Do centralised skin screening clinics increase participation in melanoma screening (Australia)?

To compare during the first 12 months of a 3-year randomised community-based trial of population screening for melanoma three methods of screening delivery: skin screening within day-to-day primary care (Group A); screening in dedicated skin screening clinics either organised privately by local physicians (Group B); or organised centrally with participants referred back to their physicians for definitive diagnosis and management (Group C).

The trial involved 18 regional communities in Queensland, Australia. Of the nine communities randomised to the intervention group, three communities were allocated to each of the Groups A, B or C. All intervention communities received a community education programme and an education and support programme for primary care physicians. The self-reported prevalence of clinical skin examination was assessed by surveying 3,110 residents (66.9% participation rate) aged > or = 30 years by telephone at baseline, and 14,060 residents (70.9% participation rate) by self-administered mailed questionnaire at 12-month follow-up.

At baseline the prevalence of skin screening did not differ between intervention and control communities. At 12-month follow-up, participants within intervention communities reported skin screening significantly more frequently (20.9% versus 10.9%; p < 0.001). Within intervention communities, the prevalence of clinical skin examinations in Group A was similar to that of control communities (12.6% and 10.9%; p = 0.33). Communities in Group B (16.5%; p = 0.001) and Group C (27.1%; p < 0.001) reported significantly higher prevalence of clinical examinations than the control group.

The provision of centrally organised skin screening clinics significantly increases skin screening rates and may have relevance for future melanoma control programmes.