Synopsis

EURODERMOSCOPY: PAN-EUROPEAN STUDY OF DERMOSCOPY USE

Background

Dermoscopy has become an essential tool for the early diagnosis of skin cancers and monitoring of high-risk patients. It is considered to be widely used in Europe, however very few recent reports4 exist on dermoscopy use by European dermatologists, compared with Australia1-3 or the US.
Important differences in skin cancer burden and early detection have been reported across Europe5, with late diagnosis, underdiagnosis, and poorer prognosis reported in many Central and Eastern European countries5, 6. In this context there is no available data on the differences in use of dermoscopy across Europe for dermatologists in daily practice.

Objective

1. To describe and compare the use of, training for and attitudes towards dermoscopy among dermatologists in different European countries.

2. To identify obstacles and opportunities for the use of dermoscopy and the necessities of training in dermoscopy, towards enhancing the use of dermoscopy for the diagnosis of skin diseases and the early detection of skin cancers in European countries.

Methodology

1. Study design: Survey of European dermatologists through questionnaires

2. Countries participating: European countries

3. Study Coordination:
3.1. Steering Task Force
3.1.1. Steering Task Force Members (alphabetically):
 Giuseppe Argenziano,
 Ana-Maria Forsea,
 Alan C Geller
 Veronique del Marmol
 Peter H Soyer
 Iris Zalaudek
3.1.2. Steering Task Force roles
 draft the core questionnaire
 select the National Coordinators/Coordinating Teams
 draft the time-line, budget and potential funding applications for the study.
 ensure the communication with the National Coordinating Teams,
 motivate and support the activity of National Coordinating Teams
 supervise the centralized dissemination and collection of data
 supervise the analysis of final data and the publication of results
3.2. National Coordinating Teams: Responsibilities include:
 have access to the national database of dermatologists
 provide the translation of the survey questionnaire in the national language;
 obtain the necessary approvals at national level for conducting the survey;
 ensure the dissemination of the survey to dermatologists nationwide
 actively encourage and motivate dermatologists participation nationwide;
 collect the results (for the responses that are not online)
 supervise the analysis and publication of data for the respective country;
 participate at the elaboration and publication of the final report of the study.
Each National Coordinating Team will be led by a National Coordinator, who will be in charge with the communication with the Steering Task Force of the study

4. Survey: One common questionnaire, translated in each participating language. The questionnaire would contain a common core set of multiple-choice questions. Between 1 and 3 extra questions may be added by each country, depending on each specific context,

5. Survey subjects: nationwide survey of all dermatologists registered in each participating country (source: national physician register, national dermatologic society etc.)

6. Survey dissemination and results collection: online survey, using the IDS platform. Additionally, in each participating country, other methods may be used (post mail, e-mail, fax, phone interview etc.), at the choice of the national coordinator, taking into account the specific of the survey subjects in each country.

Expected results

1. Obtain an overview of the profile, training, practice and attitudes of the dermatologists practicing dermoscopy in European countries

2. Identify the patterns of dermoscopy use in the countries with reported difficulties of early detection of melanoma and other skin cancers

3. Identify the obstacles in the use of dermoscopy in different countries/regions.
4. Identify the necessities of dermoscopy training.

5. Identify the most effective strategies to enhance the use of dermoscopy towards the improvement of skin cancer early detection in the countries with low survival.

References

1. Venugopal SS, Soyer HP, Menzies SW. Results of a nationwide dermoscopy survey investigating the prevalence, advantages and disadvantages of dermoscopy use among Australian dermatologists. Australas J Dermatol. Feb;52(1):14-18.
2. Engasser HC, Warshaw EM. Dermatoscopy use by US dermatologists: a cross-sectional survey. J Am Acad Dermatol. Sep;63(3):412-419, 419 e411-412.
3. Terushkin V, Oliveria SA, Marghoob AA, Halpern AC. Use of and beliefs about total body photography and dermatoscopy among US dermatology training programs: an update. J Am Acad Dermatol. May;62(5):794-803.
4. Moulin C, Poulalhon N, Duru G, Debarbieux S, Dalle S, Thomas L. Dermoscopy use by French private practice dermatologists: a nationwide survey. Br J Dermatol. Jan;168(1):74-79.
5. Forsea AM, Del Marmol V, de Vries E, Bailey EE, Geller AC. Melanoma incidence and mortality in Europe: new estimates, persistent disparities. Br J Dermatol. Nov;167(5):1124-1130.
6. de Vries E, Coebergh JW. Cutaneous malignant melanoma in Europe. Eur J Cancer. Nov 2004;40(16):2355-2366.
Contact: Ana-Maria Forsea, study coordinator, aforsea@yahoo.com