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Dermatology Research and Practice
Volume 2014, Article ID 294287, 6 pages
Clinical Study

Health-Care Delay in Malignant Melanoma: Various Pathways to Diagnosis and Treatment

1Department of Nursing, Umeå University, Umeå, Sweden
2Department of Clinical Sciences, Division of Psychiatry and Medical Psychology, Umeå University, Umeå, Sweden
3Department of Public Health and Clinical Medicine, Dermatology and Venereology, Umeå University, Umeå, Sweden

Received 17 July 2013; Revised 13 October 2013; Accepted 14 October 2013; Published 5 January 2014

Academic Editor: Giuseppe Argenziano

Copyright © 2014 Senada Hajdarevic et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We aimed to describe and compare patients diagnosed with malignant melanoma (MM), depending on their initial contact with care and with regard to age, sex, and MM type and thickness, and to explore pathways and time intervals (lead times) between clinics from the initial contact to diagnosis and treatment. The sample from northern Sweden was identified via the Swedish melanoma register. Data regarding pathways in health care were retrieved from patient records. In our unselected population of 71 people diagnosed with skin melanoma of SSM and NM types, 75% of patients were primarily treated by primary health-care centres (PHCs). The time interval (delay) from primary excision until registration of the histopathological assessment in the medical records was significantly longer in PHCs than in hospital-based and dermatological clinics (Derm). Thicker tumors were more common in the PHC group. Older patients waited longer times for wide excision. Most MM are excised rapidly at PHCs, but some patients may not be diagnosed and treated in time. Delay of registration of results from histopathological assessments within PHCs seems to be an important issue for future improvement. Exploring shortcomings in MM patients’ clinical pathways is important to improve the quality of care and patient safety.