OBJECTIVES: The aim of the present study was to determine the role of general practitioners, self-medication, alternative therapies and self-examination in diagnostic delay in case of malignant melanoma patients.

METHODS: We carried out a survey including medical record analysis and questionnaire survey in patients diagnosed within five years with cutaneous malignant melanoma at the Pécs Dermatological Clinic (n=362). The investigation involved: delay rate, clinical characteristics of the tumor, sociodemographic factors, oncology vigilance of the general practitioner, application of self-medication, alternative therapies and self-examination. Logistic regression was used with 95% probability level (p<0.05).

RESULTS: The mean age was 54.5. Breslow tumor thickness was above 4 mm in 12.2% of patients. The mean delay was 8.1±15.6 months, median: 6 months. In case of patients who were undressed up from waist in some occasions (53.3%, OR=1.9 [95%CI:1.08-3.5]), or never (25.7%, OR=2.9, 95%CI:1.4-5.9) during medical visits in the period prior to the diagnoses, Breslow tumor thickness was more likely above 1.01 mm, but did not affect the patient delay. Skin of 75.4% of patients were never examined by the practitioner, however it did not affect delay. In case of 69.9% of the respondents GP never asked whether they recognize any skin lesions, the long delay in their case was more likely (OR: 3.4, 95%CI:1.2-9.4). 76% have never heard from the GP about skin problems. The frequency of self-medication and alternative therapy use before visiting the physician did not affected the delay and tumor parameters. Among patients who have never been conducted self-examination (50%) the chance of longer delay was higher (OR=3.2, 95%CI:1.6-6.1).

CONCLUSIONS: GPs play an important role in the early detection of melanoma lesions, propagation of self-examination, awareness raising in the recognition of signs. The vigilance of GPs is especially important in case of patients with higher-risk and disorders in less visible places.