Individuals diagnosed as having an SPM between February 1, 2010, and February 28, 2011, were included using Kaiser Permanente's KP HealthConnect EHR. Chart review was performed to determine if the SPM was diagnosed during a Kaiser Permanente–initiated annual screening TBSE or a patient-initiated encounter. Patient awareness of the lesion was also assessed. One sample t test was used to determine whether the SPM incidence in the Kaiser Permanente Hawaii population differed from the baseline melanoma incidence in Hawaii. Multiple regression analysis using stepwise backward elimination evaluated age, sex, and patient awareness of lesion as predictors of Breslow thickness. Statistical analyses were performed using SAS software, version 9.1 (SAS Institute Inc). Kaiser Permanente Hawaii's institutional review board approved this study.