Melanoma is a major public health problem with significant morbidity and mortality, and is increasing in frequency, unlike most cancer sites. The vast majority of the ultimately fatal melanomas were perfectly visible on the skin surface before they metastasized, yet they were not detected in time, hence not excised until it was too late for cure. Primary care clinicians are well-positioned to have a substantial impact on melanoma mortality by detecting these lesions on the skin surface prior to metastasis, yet we have found that they generally do not inspect the areas of the skin on which melanomas most commonly arise. This proposal seeks to change the skin examination practices of primary care physicians by developing the Basic Skin Cancer Triage curriculum into a web-based course and evaluating its efficacy in a geographically diverse sample of community-based primary care physicians. Specifically, we will develop the above course and compare it, in a randomized trial, to a web-based course in weight, diet, and physical activity assessment and counseling. Our primary outcomes will be performance of skin examination and counseling during routine primary care visits, as assessed by patient exit interviews. We will also assess self-reported ? practices and other measures. If this course is found to be efficacious, it will be made freely available on the web, and we will plan efforts to encourage its broad dissemination. ? ?

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA106592-03
Application #
7075443
Study Section
Community-Level Health Promotion Study Section (CLHP)
Program Officer
Yaroch, Amy L
Project Start
2004-06-16
Project End
2008-05-31
Budget Start
2006-06-01
Budget End
2007-05-31
Support Year
3
Fiscal Year
2006
Total Cost
$479,081
Indirect Cost
Name
Rhode Island Hospital
Department
Type
DUNS #
075710996
City
Providence
State
RI
Country
United States
Zip Code
02903
Markova, Alina; Weinstock, Martin A; Risica, Patricia et al. (2013) Effect of a web-based curriculum on primary care practice: basic skin cancer triage trial. Fam Med 45:558-68
Markova, Alina; Weinstock, Martin A; Risica, Patricia et al. (2011) The role of gender in examination and counseling for melanoma in primary care. Arch Intern Med 171:2061-3
Nunes, Anthony P; Lapane, Kate L; Weinstock, Martin A et al. (2011) Association between non-steroidal anti-inflammatory drugs and keratinocyte carcinomas of the skin among participants in the Veterans Affairs Topical Tretinoin Chemoprevention Trial. Pharmacoepidemiol Drug Saf 20:922-9
Criscione, Vincent D; Weinstock, Martin A (2010) Melanoma thickness trends in the United States, 1988-2006. J Invest Dermatol 130:793-7
Lee, Kachiu C; Weinstock, Martin A; Veterans Affairs Topical Tretinoin Chemoprevention (VATTC) Trial Group (2010) Prospective quality of life impact of keratinocyte carcinomas: observations from the Veterans Affairs Topical Tretinoin Chemoprevention Trial. J Am Acad Dermatol 63:1107-9
Rogers, Howard W; Weinstock, Martin A; Harris, Ashlynne R et al. (2010) Incidence estimate of nonmelanoma skin cancer in the United States, 2006. Arch Dermatol 146:283-7
Dore, David D; Lapane, Kate L; Trivedi, Amal N et al. (2009) Association between statin use and risk for keratinocyte carcinoma in the veterans affairs topical tretinoin chemoprevention trial. Ann Intern Med 150:9-18
Eide, Melody J; Weinstock, Martin A; Clark, Melissa A (2009) The association of physician-specialty density and melanoma prognosis in the United States, 1988 to 1993. J Am Acad Dermatol 60:51-8
Criscione, Vincent D; Weinstock, Martin A; Naylor, Mark F et al. (2009) Actinic keratoses: Natural history and risk of malignant transformation in the Veterans Affairs Topical Tretinoin Chemoprevention Trial. Cancer 115:2523-30
Eide, Melody J; Weinstock, Martin A; Clark, Melissa A (2009) Demographic and socioeconomic predictors of melanoma prognosis in the United States. J Health Care Poor Underserved 20:227-45

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