Osteopaths in the United Kingdom and Australia: Attitudes, practice, confidence and knowledge with regard to melanoma recognition – An observational questionnaire study

BackgroundMelanoma causes the majority of skin cancer deaths. Australia (AUS) has the world's highest incidence rate, whereas the United Kingdom's (UK) incidence rate is one third of that, but rising rapidly. Osteopaths, many of whom routinely look at least at a part of the patient's skin as part of their osteopathic examination, are potentially in an ideal position for melanoma recognition.ObjectiveTo investigate the current attitudes, practice, confidence and knowledge of osteopaths practising in the UK and Australia with regard to melanoma recognition.Materials and methodsA link to an electronic questionnaire was sent out by e-mail to 2368 osteopaths registered with the General Osteopathic Council (UK) and to 942 osteopaths registered with the Osteopathy Board of Australia. Descriptive and inferential statistics were applied to the quantitative data. The qualitative data were evaluated with a thematic analysis approach.ResultsFollowing exclusions, 378 responses from UK osteopaths and 137 responses from AUS osteopaths were analysed.Melanoma recognition was seen as a valuable part of osteopathic practice by 85% of all osteopaths, but the topic of melanoma constituted only a minor aspect in everyday interactions with patients and colleagues, and confidence-levels with regard to early recognition were in the medium-to-low range only. Participants did not perform better than by chance when discriminating melanoma from benign lesions in picture tests, but scored high in melanoma background knowledge.The vast majority of osteopaths relied on rule-based approaches, for example the ABC(D)(E) acronym, rather than the more promising “ugly duckling sign” (a lesion that appears different from a patient's other moles).ConclusionsUK and AUS osteopaths have a positive attitude towards melanoma recognition, however they demonstrate limited levels of confidence and knowledge. Future research should evaluate the reliability of melanoma recognition rates by osteopaths using the “ugly duckling sign” versus osteopaths using rule-based approaches.