Early diagnosis of melanoma in the province of Trento, Italy

Abstract

The Italian League Against Tumors (LILT) was founded in February 1922 in Bologna. It is an „organism” that works thanks to the commitment of all the provincial offices. (https://www.lilt.it/dove/associazioni). At LILT it carries out its activity in three directions: a)Primary prevention which promotes the spread of a healthy lifestyle with all available means; b)Secondary prevention which promotes the culture of early diagnosis through 2nd level specialist and instrumental medical visits with the aim of identifying the disease in the initial phase. c)Tertiary prevention, i.e. support for those who have been diagnosed with cancer and their family members, both during hospital treatment and in the family and social context, also taking care of psychophysical rehabilitation and social reintegration. Objective: to present the algorithm for screening pigmented skin lesions developed by the medical association LILT from Italy. Materials and methods Melanoma screening is carried out in the population starting from the age of 15 (from 13 years if one/ both parents have re-encountered Melanoma). If no moles/pathological formations are found, it is advisable to carry out subsequent visits every 1-2-3 years. Programming takes place through the contacts (telephone, email) of 11 LILT branches. The doctor goes min 1 times a month to each location (depending on need) to visit patients (15 minutes). The Heine Delta 20 dermatoscope is used, an Android mobile phone with a single central camera and/or Canon camera. A medical report sheet is issued, in which everything diagnosed during the visit and indications for the next few months/years are noted. I have an archive in which the photos of each delegation are collected, so that I can create a separate database if necessary. This way of working, with a photographic database, divided by branches, years, months, with names/surnames, etc. has proven to be very effective. Oftentimes the patient is consulted by the doctor at least 2-3 times before being sent for surgical removal of the suspected nevus. The patient shows the report to his family doctor and presents the previous reports at subsequent visits. Results: In my 10 years of activity, 42% of patients have been diagnosed with Superficial Melanoma and 58% with Melanoma in situ/borderline; 55% men/45% women. In Italy the incidence of Melanoma is 9% in men (0-49 years (2nd place) and 7% in women (0-49 years, 3rd place). I have had several cases of repeated Melanomas, the subsequent they were MM in situ, thanks to follow-up visits. Discussions I have participated in numerous training courses and national conferences dedicated to the early diagnosis of Melanoma and other skin tumors, including the International Masterclass on Dermoscopy, organized in Rome in 2022. Rare/difficult cases were discussed, and reported by each participant; the latest scientific/ dermatological data in prevention and treatment. I actively participated in the creation of the „Informative Atlas of Skin Tumors” intended for doctors (especially family doctors). I present at this Congress some of the most interesting cases, accompanied by histological reports. Conclusions Melanoma screening according to the LILT model can be introduced in the Republic of Moldova for the benefit of the population.