인문학
사회과학
자연과학
공학
의약학
농수해양학
예술체육학
복합학
DBpia AI
AI 에이전트
AI 아이디어
AI 리더
AI 뷰어
Citeasy
크롬 서지관리 다운로드
지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
초록·키워드
The systematic review by Gooley et al. in this issue of JEADV Clinical Practice provides a timely and sobering overview of interventions aimed at increasing skin self-examination (SSE) among individuals at high risk of melanoma [1]. Their analysis of 13 randomized controlled trials shows that, despite multiple educational, digital and partner-assisted approaches, evidence supporting a real clinical benefit of these interventions remains weak. Improvements in self-reported frequency or completeness of SSE are inconsistently observed, and—most importantly—no reduction in advanced melanoma or mortality has yet been demonstrated. This conclusion echoes a persistent gap observed in clinical practice: the dissociation between awareness and behaviour. In two previous studies from our group, we assessed both individuals at high risk of melanoma and patients already diagnosed with melanoma [2, 3]. In both settings, knowledge about melanoma risk factors and prevention was remarkably high—over 85% of respondents achieved adequate knowledge scores—yet adherence to recommended preventive behaviours, especially SSE, was strikingly low. Only 24% of high-risk subjects and 14% of melanoma patients performed an optimal self-examination covering ≥ 80% of the body surface monthly. Even under regular specialist surveillance, many reported sunburns and suboptimal photoprotection. These findings illustrate a paradox well summarized by Gooley et al.: knowledge and motivation do not necessarily translate into sustained preventive action. The behavioural gap appears multifactorial—ranging from psychological factors (over-reliance on physician follow-up, decreased perceived vulnerability, anxiety avoidance) to practical limitations (time constraints, physical flexibility or embarrassment in examining intimate areas). Interventions focused solely on education or digital reminders seem insufficient when detached from behavioural reinforcement and social support mechanisms. Interestingly, the most promising approaches in the reviewed trials involved the participation of a ‘skin check partner’. In our experience, as well, partner-assisted SSE improves the completeness of examination of otherwise inaccessible areas such as the back or scalp. Nevertheless, such strategies require careful design to avoid excessive medicalization or anxiety. The balance between vigilance and quality of life remains delicate, particularly in patients who are already under intense medical follow-up. The review also underscores the methodological weaknesses that hinder progress in this field. Most RCTs rely on self-reported outcomes, short follow-up and small, heterogeneous samples. There is an urgent need for multicenter studies incorporating objective measures of SSE performance (e.g., digital photo documentation, AI-assisted lesion tracking) and clinically relevant endpoints such as Breslow thickness at diagnosis or stage distribution. From a practical standpoint, clinicians should recognize that merely providing information or recommending SSE is not enough. Structured behavioural interventions—combining tailored education, periodic reinforcement, technological aids and involvement of partners or family members—may be necessary to achieve meaningful adherence. Moreover, adherence should be viewed not as a static outcome but as a dynamic process that fluctuates over time, influenced by age, gender, education and psychological resilience. Ultimately, improving secondary prevention in melanoma requires moving beyond knowledge dissemination toward behavioural integration. The challenge for the next decade will be to design interventions that are not only evidence-based but also human-centred—addressing real-life barriers, emotional factors and cultural contexts. Gooley et al. remind us that awareness is essential, but adherence saves lives. The author declares no conflicts of interest. Data sharing is not applicable to this article as no new data were created or analysed in this study.
인공지능 문자 인식 모델을 통해 추출된 텍스트로, 일부 오타나 오류가 포함될 수 있으나 지속적으로 개선 중입니다.
오류를 발견하셨다면 해당 부분을 드래그한 후 ' 를 통해 신고해주세요.
오류를 발견하셨다면 해당 부분을 드래그한 후 ' 를 통해 신고해주세요.
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