Informal recommendations suggest that surgery to excise a melanoma should be scheduled within four to six weeks after a biopsy and diagnosis. A recent study, published online in JAMA Dermatology, analyzed 32,501 cases of Medicare beneficiaries with diagnoses of melanoma.
Sixty-one percent of the patients were likely to be aged 75 or more years and to have no prior melanoma (94 percent). Researchers found that within the study population, 78 percent had melanomas excised within 1.5 months. For 8.1 percent of the study population, excision occurred within three months.
Among patients aged 85 years or more, there was a significant surgical delay compared with patients aged fewer than 65 years, those individuals with prior melanoma and those with coexisting medical conditions.
Findings show that people who had their biopsies performed by a dermatologist were less likely to have surgery delayed than those who had their biopsies done by a nondermatologist and excised by a primary care physician.
“Although no gold standard exists to judge appropriate versus inappropriate surgical delay, minimization of delay is an important patient-centered objective of high-quality dermatologic care, especially given the potential harms of psychological stress associated with untreated malignant neoplasms,” the authors conclude.
By improving patient access to skin care provided by dermatologists and coordination of care with other specialties, the authors believe the delays can be reduced.