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

• Published in: British journal of cancer 2000-05, Vol.82 (9), p.1605-1609
• Main Authors: Melia, J, Harland, C, Moss, S, Eiser, J R, Pendry, L
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Cancer Research; Dermatology; Drug Resistance; Epidemiology; Feasibility; Feasibility Studies; Humans; Male; Mass Screening; Medical research; Medical sciences; Melanoma; Melanoma - diagnosis; Melanoma - epidemiology; Middle Aged; Molecular Medicine; Oncology; Population Surveillance; Questionnaires; Regular; regular-article; Risk factors; Self evaluation; Sensitivity and Specificity; Skin cancer; Skin Neoplasms - diagnosis; Skin Neoplasms - epidemiology; Surveys and Questionnaires; Tumors of the skin and soft tissue. Premalignant lesions
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1054/bjoc.2000.1183

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