208 Multiple primary melanomas: Prevalence and outcomes

208 Multiple primary melanomas: Prevalence and outcomes A Nosrati, S Goel, J McGuire, B Grimes, RK Singh, K Lee, VB Morhenn, A Griffin and ML Wei 1 University of California, San Francisco, CA and 2 Veterans Affairs Medical Center, San Francisco, CA We investigated the characteristics and outcomes of individuals with multiple primary melanomas (MPM) compared with individuals with a single primary melanoma (SPM) to identify risk factors for developing MPM and whether outcomes differed between these groups. 7,268 individuals diagnosed with melanoma from 1983-2013 were identified at a tertiary referral academic center for a retrospective observational study. 6963 individuals (95.8%) had a SPM and 305 (4.2%) had MPM. Mean follow-up interval was 17 y (median 14.6, CI 95%13.715.4). MPM patients were more likely to be older (mean age 60.2 vs 55.8 y; P 1 mm. Overall survival was significantly better for patients with MPM when calculated by designating the index tumor as either the first occurring tumor (HR1⁄40.73, 95%CI 0.599-0.891) or the first invasive tumor (HR1⁄40.8, 95%CI 0.652-0.992). Overall survival was also increased when the thickest tumor was designated as the index tumor (HR1⁄40.86, 95%CI 0.7-1.06), however this did not reach significance. Melanoma specific survival was increased in MPM patients, but not significantly. In summary, MPM patients are more frequently older, white, male individuals with family history of melanoma. MPM patients have an increased rate of selected internal malignancies and overall survival but similar melanoma-specific survival rate compared with those with SPM. 209 No psychological harm from melanoma screening by PCPs: Preliminary results PM Risica, L Dionne, J Mello, LK Ferris, G Alan, M Saul, J Kirkwood and MA Weinstock 1 Brown University, Providence, RI, 2 VA Med CTR, Providence, RI, 3 University of Pittsburgh, Pittsburgh, PA and 4 Harvard University, Cambridge, MA Screening for melanoma may save lives, but may also cause patient distress. In January 2014, the University of Pittsburgh Medical Center launched a melanoma screening program for primary care providers (PCPs) offering INFORMED, a validated web-based training for detection of skin cancers, especially melanoma, to all PCPs and promoting annual skin screening of all patients age 35. We report the results of the first 139 telephone surveys of UPMC patients indicated by e medical record to having been screened to identify potential effects of the screening process. Measures of anxiety, depression and other distress were queried in addition to questions about screening activities, resources provided, and future intentions regarding skin cancer prevention. Patients surveyed were mostly white, non-Latino, female, with college or higher education, and of higher household income. Of those surveyed 42% were determined to have been thoroughly screened by their PCP as indicated by selfreport (35%) or by report of level of undress and skin areas examined consistent with thorough examination (6%). The remaining 58% were unaware the PCP screening, but may have been screened by another provider. Low numbers of participants reported potentially concerning anxiety (5 PCP screened of 7 overall) and depression (1 PCP screened of 2 overall). No differences in distress measures were found between screening groups. However, those with PCP screening were more likely to have been counseled to perform regular skin selfexamination (53%) and have been provided with written information (33%) compared to those not screened (27, 6% respectively, all p<.01). These data are subject to limitations including the several months’ time lag between screening and the survey. However, they suggest that screening for melanoma by PCPs occurred without increasing psychological symptoms. The sample will be enlarged to over 200 patients to better understand the impact of PCP screening.