Sensitivity and specificity of self-examination for cutaneous malignant melanoma risk factors

We wanted to determine whether self-examination for skin pigmentary characteristics associated with cutaneous malignant melanoma might help identify persons at high risk for this cancer. Dermatology patients without melanoma were asked to record the number of freckles on the right forearm, number of palpable arm nevi, and nevi greater than five millimeters in diameter on the entire body (factors that have been associated with increased risk for malignant melanoma). Each participant was independently examined for the same features in a standardized clinical exam. With the exam as the standard, we determined sensitivities and specificities for each of these characteristics at several different cutpoints. Specificity ranged from 83% to more than 95% for these three cutaneous markers. Sensitivity was 88% or higher for freckling status, 63% for detecting one or more palpable arm nevus, and 68% for detecting large nevi. These results indicate that self-exam may be useful in identifying individuals at high risk for melanoma.