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Identifying people at higher risk of melanoma across the U.K.: a primary-care-based electronic survey.

Accepted version
Peer-reviewed

Type

Article

Change log

Authors

Usher-Smith, JA 
Kassianos, AP 
Emery, JD 
Abel, GA 
Teoh, Z 

Abstract

BACKGROUND: Melanoma incidence is rising rapidly worldwide among white populations. Defining higher-risk populations using risk prediction models may help targeted screening and early detection approaches. OBJECTIVES: To assess the feasibility of identifying people at higher risk of melanoma using the Williams self-assessed clinical risk estimation model in U.K. primary care. METHODS: We recruited participants from the waiting rooms of 22 general practices covering a total population of > 240 000 in three U.K. regions: Eastern England, North East Scotland and North Wales. Participants completed an electronic questionnaire using tablet computers. The main outcome was the mean melanoma risk score using the Williams melanoma risk model. RESULTS: Of 9004 people approached, 7742 (86%) completed the electronic questionnaire. The mean melanoma risk score for the 7566 eligible participants was 17·15 ± 8·51, with small regional differences [lower in England compared with Scotland (P = 0·001) and Wales (P < 0·001), mainly due to greater freckling and childhood sunburn among Scottish and Welsh participants]. After weighting to the age and sex distribution, different potential cut-offs would allow between 4% and 20% of the population to be identified as higher risk, and those groups would contain 30% and 60%, respectively of those likely to develop melanoma. CONCLUSIONS: Collecting data on the melanoma risk profile of the general population in U.K. primary care is both feasible and acceptable for patients in a general practice setting, and provides opportunities for new methods of real-time risk assessment and risk stratified cancer interventions.

Description

Keywords

Adult, Aged, Early Detection of Cancer, Feasibility Studies, Female, General Practice, Hair Color, Humans, Male, Melanoma, Melanosis, Middle Aged, Residence Characteristics, Risk Assessment, Rural Health, Sex Distribution, Skin Neoplasms, Sunburn, Surveys and Questionnaires, United Kingdom, Urban Health, Young Adult

Journal Title

Br J Dermatol

Conference Name

Journal ISSN

0007-0963
1365-2133

Volume Title

Publisher

Oxford University Press (OUP)
Sponsorship
National Institute for Health Research (Clinician Scientist award RG 68235, Clinical Lecturer), National Health and Medical Research Council (Practitioner Fellowship), Public Health Wales, Betsi Cadwaladr University Health Board