title: Do centralised skin screening clinics increase participation in melanoma screening (Australia)?
abstract: OBJECTIVE
  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).
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  The provision of centrally organised skin screening clinics significantly increases skin screening rates and may have relevance for future melanoma control programmes.
authors.affiliation: Viertel Centre for Research in Cancer Control, Queensland Cancer Fund, Spring Hill, PO Box 201, QLD 4004, Brisbane, Queensland, Australia.
authors.forename: Monika
authors.initials: M
authors.lastname: Janda
authors.forename: John B
authors.initials: JB
authors.lastname: Lowe
authors.forename: Mark
authors.initials: M
authors.lastname: Elwood
authors.forename: Ian T
authors.initials: IT
authors.lastname: Ring
authors.forename: Philippa H
authors.initials: PH
authors.lastname: Youl
authors.forename: Joanne F
authors.initials: JF
authors.lastname: Aitken
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D001315:Australia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008545:Melanoma / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012878:Skin Neoplasms / Q000175:diagnosis / Q000453:epidemiology*