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.
Melia
J
J
Cancer Screening Evaluation Unit, Section of Epidemiology, Sutton, Surrey, UK.
Harland
C
C
Moss
S
S
Eiser
J R
JR
Pendry
L
L
D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D006801:Humans; D008297:Male; D008403:Mass Screening; D008545:Melanoma / Q000175:diagnosis* / Q000453:epidemiology; D008875:Middle Aged; D011159:Population Surveillance; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D011795:Surveys and Questionnaires