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Diagnostic monitoring in high-risk patients: is it cost-effective?

Binder, M.

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doi: 10.1097/01.cmr.0000382750.09636.2c
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Patients with multiple atypical moles and especially patients with familial atypical mole and multiple melanoma (FAMMM) bear a substantially increased risk for developing cutaneous melanoma. Recently it has been demonstrated that the early diagnosis of melanoma is reducing direct and indirect cost for follow-up and treatment. Beside routine clinical follow-up with the unaided eye additional techniques are being used to follow these high risk patients sequentially. Which technique does allow to follow-up these patients efficiently and accurately? Can we identify a method also exhibiting cost-efficiency? Dermatoscopy and digital dermatoscopy are generally accepted methods increasing the diagnostic sensitivity and specificity. It seems therefore quite logically that using dermatoscopy by increasing the diagnostic accuracy will decrease cost from melanoma which has not been diagnosed at the earliest possible stage. Other methods such as whole-body photographic mapping also might be useful for following patients at high-risk for developing melanoma. Still, formal studies on cost-efficiency of various techniques in high-risk patients are missing. The recent literature on this issue will be discussed and interpreted in detail.

© 2010 Lippincott Williams & Wilkins, Inc.