Symptom interpretation as a source of delay in malignant melanoma presentation — A literature review

Objectives The principle aim of this paper is to explore the available evidence based literature examining the significance of symptom interpretation as an influencing factor in malignant melanoma presentation delay. Method A comprehensive review of the literature relating to presentation delay in melanoma was undertaken. A search strategy using the key words; malignant melanoma, cancer, presentation, delay, symptom interpretation, signs, symptoms and help seeking was devised to interrogate electronic medical, nursing and psychological databases. Twelve original English language papers that met the inclusion criteria were included. Results A number of influencing factors associated with symptom interpretation in malignant melanoma were identified. These included knowledge and awareness, the nature of the symptoms and previous experience of benign diagnosis. Conclusions Delay was associated with incorrect interpretation of symptoms, minimisation of significance of signs of malignant melanoma, and outcomes from previous help seeking behaviour. Only limited evidence was available and further research needs to be targeted on further examination of presentation journeys and possible benefits of the internet and other media for enhancing knowledge and encouraging translation to aid interpretation and initiate self referral to specialist service