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European Journal of Dermatology

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Inequalities in the patterns of dermoscopy use and training across Europe: conclusions of the Eurodermoscopy pan-European survey Volume 30, numéro 5, September-October 2020

Auteurs
H. Peter Soyer Eurodermoscopy Working Group6a 5
1 Dermatology Department, Elias University Hospital, Carol Davila University of Medicine and Pharmacy Bucharest, Romania
2 Department of Dermatology, Medical University of Vienna; Vienna, Austria
3 Dermatology Clinic, Hospital Maggiore, University of Triest, Italy
4 Dermatology Department, Universite Libre de Bruxelles, Hopital Erasme, Brussels, Belgium
5 Dermatology Research Centre, The University of Queensland, The University of Queensland Diamantina Institute, Brisbane, Australia
6 Eurodermoscopy Working Group Members
7 Dermatology Unit, University of Campania, Naples, Italy
8 Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
* Reprints
a Eurodermoscopy working group members: Monika ARENBERGEROVA Department of Dermatology, Third Medical Faculty, Charles University Prague, Czech Republic Angelo AZENHA Hospital Privado da Trofa, Portugal Andreas BLUM DermPrevOncol, Public, Private and Teaching Practice of Dermatology, Konstanz, Germany Jonathan C. BOWLING Private Practice Nuffield Hospital, Oxford, UK Ralph P. BRAUN Department of Dermatology, University Hospital of Zürich, Switzerland Matilda BYLAITE-BUCINSKIENE Centre of Dermatovenereology, Vilnius University, Vilnius, Lithuania Leo ČABRIJAN Department of Dermatovenereology, Clinical Hospital Center Rijeka, Rijeka, Croatia Hristo DOBREV Department of Dermatology and Venereology, Medical Faculty, Medical University, Plovdiv, Bulgaria Hana HELPPIKANGAS Dermatology Department, Clinical Center, University of Sarajevo, Bosnia & Herzegovina Raimonds KARLS Department of Infectology and dermatology, Riga Stradins University, Derma Clinic Riga, Latvia Uladzimir KRUMKACHOU, Dermatovenereology and Cosmetology Department, Belarusian Medical Academy of Post-Graduate Education, Minsk, Belarus Nicole KUKUTSCH Department of Dermatology, Leiden University Medical Center, The Netherlands Iona McCORMACK Belfast Health & Social Care Trust, Belfast, Northern Ireland Lali MEKOKISHVILI Dermatovenereology Department at Caucasus International University, Tbilisi, Georgia Nir NATHANSOHN Department of Dermatology and the Advanced Technologies Center, C. Sheba Medical Center, Tel Hashomer, Israel Kari NIELSEN Lund University, Helsingborg Hospital, Department of Clinical Sciences Lund, Dermatology and Venereology, Lund, Sweden Judit OLAH Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary Fezal ÖZDEMIR Private Practice, Alsancak, Izmir, Turkey Susana PUIG Melanoma Unit, Dermatology Department, Hospital Clínic & IDIBAPS (Institut d’Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain. Centro Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain. Departament de Medicina, Universitat de Barcelona, Barcelona, Spain. Pietro RUBEGNI Department of Dermatology, University of Siena, Siena, Italy Tanja Planinsek RUCIGAJ Dermatovenereological Clinic, University Medical Centre Ljubljana, Slovenia Thomas R. SCHOPF Norwegian Centre for E-health Research, University Hospital of North-Norway, Tromsø, Norway Vasily SERGEEV Central Research Dermatology Clinic, Moscow, Russia Alexander STRATIGOS 1st Department of Dermatology - Venereology, National and Kapodistrian University of Athens School of Medicine, Andreas Sygros Hospital, Athens, Greece Luc THOMAS Lyon 1 University, Dermatology Center Hospitalier Lyon Sud, and Lyons Cancer Research Center INSERM U1052 - CNRS UMR5286 - Lyon France Danica TIODOROVIC Clinic of Dermatovenerolgy, Clinical Center of Nis, Medical Faculty, Nis, Serbia Ave VAHLBERG Vahlberg & Pild Ltd, Tallinn, Estonia Zorica ZAFIROVIK University Clinic of Dermatology, Medical Faculty, University “St. Cyril and Methodius”, Skopje, Republic of North Macedonia

Background:Dermoscopy is a widely used technique, recommended in clinical practice guidelines worldwide for the early diagnosis of skin cancers. Intra-European disparities are reported for early detection and prognosis of skin cancers, however, no information exists about regional variation in patterns of dermoscopy use across Europe. Objective: To evaluate the regional differences in patterns of dermoscopy use and training among European dermatologists. Materials & Methods:An online survey of European-registered dermatologists regarding dermoscopy training, practice and attitudes was established. Answers from Eastern (EE) versus Western European (WE) countries were compared and their correlation with their respective countries’ gross domestic product/capita (GDPc) and total and government health expenditure/capita (THEc and GHEc) was analysed. Results: We received 4,049 responses from 14 WE countries and 3,431 from 18 EE countries. A higher proportion of WE respondents reported dermoscopy use (98% vs. 77%, p<0.001) and training during residency (43% vs. 32%) or anytime (96.5% vs. 87.6%) (p<0.001) compared to EE respondents. The main obstacles in dermoscopy use were poor access to dermoscopy equipment in EE and a lack of confidence in one's skills in WE. GDPc, THEc and GHEc correlated with rate of dermoscopy use and dermoscopy training during residency (Spearman rho: 0.5-0.7, p<0.05), and inversely with availability of dermoscopy equipment. Conclusion: The rates and patterns of dermoscopy use vary significantly between Western and Eastern Europe, on a background of economic inequality. Regionally adapted interventions to increase access to dermoscopy equipment and training might enhance the use of this technique towards improving the early detection of skin cancers.