Feasibility of targeted early detection for melanoma: a population-based screening study

The feasibility of targeted screening for cutaneous malignant melanoma in the UK using a postal questionnaire and invitation to screening by a consultant dermatologist was investigated in a population based cross-sectional survey. A total of 1600 people aged 25–69 years, stratified by the social deprivation score of wards within one general practice, were randomly selected from a population of 8000.1227 (77%) returned the questionnaire and 896 (56%) attended the screening clinic. Uptake was lower for men (P< 0.001), those aged under 50 (P< 0.001), people from deprived areas (P< 0.001) and skin types III and IV (men only, P< 0.001). Twenty per cent of women and 10% of men felt nervous about attending the clinic, but only 4% were worried by the questionnaire. The level of agreement between the self- and dermatologist’s assessments of risk factors was best for hair colour (Kappa = 0.67, sensitivity 73% and specificity 98%). People tended to under-report their level of risk. Over 95% knew about at least one major sign, but 54% reported incorrect signs of melanoma. Targeted screening for melanoma in the UK will be hampered by difficulties in accurately identifying the target population. Strategies to improve skin self-awareness rather than screening should be developed and evaluated. © 2000 Cancer Research Campaign

[1]  M. Delgado-Rodríguez,et al.  The naevus count on the arms as a predictor of the number of melanocytic naevi on the whole body , 1999, The British journal of dermatology.

[2]  R. Pill,et al.  Can primary prevention or selective screening for melanoma be more precisely targeted through general practice? A prospective study to validate a self administered risk score , 1998, BMJ.

[3]  Rod Sinclair Commentary: Start with the KISS principle , 1998 .

[4]  U. Ringborg,et al.  Screening for Cutaneous Malignant Melanoma: A Feasibility Study , 1996, Journal of medical screening.

[5]  D. Keeley Commentary: Screening for melanoma risk is misguided , 1995, BMJ.

[6]  P. Little,et al.  Self screening for risk of melanoma: validity of self mole counting by patients in a single general practice , 1995, BMJ.

[7]  J. Elwood Screening for Melanoma and Options For-Its Evaluation , 1994, Journal of medical screening.

[8]  R. MacKie,et al.  Audit of public education campaign to encourage earlier detection of malignant melanoma. , 1992, BMJ.

[9]  U. Ringborg,et al.  Early detection and prevention of cutaneous malignant melanoma: Emphasis on Swedish activities , 1991, Medical oncology and tumor pharmacotherapy.

[10]  R. MacKie,et al.  Clinical recognition of early invasive malignant melanoma. , 1990, BMJ.

[11]  V. Carstairs,et al.  Deprivation and health in Scotland. , 1990, Health bulletin.

[12]  R. MacKie,et al.  PERSONAL RISK-FACTOR CHART FOR CUTANEOUS MELANOMA , 1989, The Lancet.

[13]  J. R. Landis,et al.  The measurement of observer agreement for categorical data. , 1977, Biometrics.

[14]  J. Cuzick,et al.  The association between naevi and melanoma in populations with different levels of sun exposure: a joint case-control study of melanoma in the UK and Australia. , 1998, British Journal of Cancer.

[15]  J. Melia,et al.  Early detection of cutaneous malignant melanoma in Britain. , 1995, International journal of epidemiology.

[16]  R. Marsden,et al.  Screening for skin cancer: experience of an occupational health screening programme. , 1993, Occupational medicine.