Evaluating the usefulness of self-reported risk factors in a skin cancer screening program

The objective of this study was to describe the risk factor profile of skin cancer screening participants and to determine whether there is an association between the number of skin cancer/melanoma risk factors and the likelihood of diagnosis of a malignant melanoma. Seventy skin cancer screening clinics were held by the Lions Cancer Institute in predominantly rural areas of Western Australia between 1996 and 2003. Participants were self-selected and voluntary, responding to an advertisement seeking people at 'high-risk' of melanoma. The Lions Cancer Institute skin screening clinics targeted participation by individuals with three or more of the established risk factors for skin cancer/melanoma. Questionnaires collecting information on the self-report of nine risk factors were completed by 5950 participants who were screened for melanoma between 1996 and 2003. The number and type of risk factors, and of provisionally diagnosed and histopathologically confirmed malignant melanomas were measured. Of 5950 participants, 18 histopathologically confirmed malignant melanomas were detected. A participant's total number of risk factors showed some association with the provisional melanoma diagnosis given at the time of screening. No relationship, however, was observed between the number of risk factors and a melanoma that was histopathologically confirmed after screening. The risk factor method is effective in selecting a 'high risk' population, but does not seem to have high value in predicting who will be diagnosed with melanoma as a result of screening. Further studies are needed to verify this finding owing to the rarity of melanoma and the small number of confirmed melanomas in this study.