Communication About Family Members' Risk of Melanoma: Self-reported Practices of Dermatologists in the United States.

Oliveria SA, Heneghan MK, Halpern AC, Hay JL, Geller AC.

Source

Department of Medicine (Drs Oliveria and Halpern and Ms Heneghan), and Psychiatry Service, Department of Psychiatry and Behavioral Sciences (Dr Hay), Memorial Sloan-Kettering Cancer Center, New York, New York; and Division of Public Health Practice, Harvard School of Public Health, Boston, Massachusetts (Mr Geller).

Abstract

Objectives To assess current self-reported communication and screening practices of dermatologists to their patients with melanoma about family members' risk of melanoma at the time of diagnosis and to understand the barriers that dermatologists encounter in communicating risk to patients.

DESIGN:

Descriptive survey study.

SETTING:

Office-based practicing physicians in the United States.

PARTICIPANTS:

One thousand dermatologists. Main Outcome Measure Melanoma risk communication practices.

RESULTS:

Of 974 eligible dermatologists, 406 completed the survey (response rate, 41.7%). Almost 85% of dermatologists reported that they often or always communicate risk to patients with melanoma about their first-degree relatives, and almost 80% reported that they often or always advise their patients with melanoma that their older children (≥18 years) may be at greater risk of skin cancer. However, less than 50% of dermatologists routinely offered to screen first-degree relatives who live nearby, while only 19.7% used medical record reminders to note communication of melanoma risk to family members. Most dermatologists reported no major barriers to melanoma risk communication. However, the presence of "any risk communication barrier" (time constraints, absence of guidelines, or lack of written material) was associated with reduced melanoma risk communication practices by dermatologists.

CONCLUSIONS:

The observed high rates of self-reported risk communication by dermatologists to patients with melanoma about their first-degree family members are encouraging. However, the reported low rates of actual screening of first-degree relatives warrant easy-to-administer office-based medical record reminders to facilitate and optimize screening of at-risk relatives.