指南建议黑色素瘤患者至少每年接受一次皮肤科检查。随访依从性及其对生存的影响尚不清楚。 确定原发性皮肤黑色素瘤患者每年皮肤科随访的依从性水平，确定更好依从性的预测因素，并评估依从性是否与黑色素瘤相关死亡率相关。对 2010 年至 2013 年加拿大安大略省原发性侵袭性黑色素瘤成人患者进行回顾性起始队列分析，并随访至 2018 年 12 月 31 日 结果：对皮肤科随访的遵守情况各不相同，只有 28.0% 的患者至少每年去看一次皮肤科医生（中位随访时间 5.0 年）。年龄较小、女性、收入较高、更容易获得皮肤科护理、2/3 期黑色素瘤、既往角质形成细胞癌、较少合并症以及黑色素瘤诊断前 12 个月内的任何门诊就诊都是依从性的预测因素。与较低的依从性水平相比，较高的依从性每年皮肤科就诊与黑色素瘤特异性死亡率的降低相关（调整后的风险比 0.64，95% CI 0.52-0.78）。观察性研究设计和无法识别非皮肤科医生进行的皮肤检查结论：黑色素瘤诊断后每年去皮肤科就诊的依从性较低。更大的依从性可能会促进更好的患者生存，但需要进一步研究（包括随机试验）进行确认。版权所有 © 2024。由 Elsevier Inc. 出版。

Guidelines recommend that patients with melanoma undergo dermatologic examination at least annually. Adherence to follow-up and its impact on survival are unclear.To determine the level of adherence to annual dermatologic follow-up in patients with primary cutaneous melanoma, identify predictors for better adherence, and evaluate whether adherence was associated with melanoma-related mortality.Retrospective inception cohort analysis of adults with primary invasive melanoma in Ontario, Canada from 2010-2013 with follow-up until December 31, 2018 RESULTS: Adherence to dermatologic follow-up was variable with only 28.0% of patients seeing a dermatologist at least annually (median follow-up 5.0 years). Younger age, female sex, higher income, greater access to dermatology care, stage 2/3 melanoma, prior keratinocyte carcinoma, fewer comorbidities, and any outpatient visit in the 12 months prior to melanoma diagnosis were predictors for adherence. Greater adherence to annual dermatology visits was associated with reduced melanoma-specific mortality compared with lower levels of adherence (adjusted hazard ratio 0.64, 95% CI 0.52-0.78).Observational study design and inability to identify skin examinations performed by non-dermatologists CONCLUSION: Adherence to annual dermatology visits after melanoma diagnosis was low. Greater adherence may promote better patient survival but warrants confirmation in further research including randomized trials.Copyright © 2024. Published by Elsevier Inc.