Identifying individuals at high risk of melanoma: a simple tool.
Simple and reliable tools for identifying patients at high risk for melanoma with preventive measures have important public health implications. An individual risk score for cutaneous melanoma was constructed and externally validated. With the summary coefficients of the risk factors for cutaneous melanoma, derived from a meta-analysis, a melanoma risk score was tested in an Italian population and externally validated in a Brazilian population. Common nevi, skin and hair color, freckles, and sunburns in childhood were the variables included in the final predictive model. The discriminatory ability of the models was assessed by the receiver operating characteristic (ROC) curve. The performance of the model was also evaluated by conducting an external validation. The area under the curve (AUC) of the candidate model was 0.79 (95% confidence interval: 0.75-0.82). The same model, when applied in the Brazilian population, presented an AUC of 0.79 (95% confidence interval: 0.70-0.86). At the cut-off level of 3 and more, 89 and 80% of the melanoma cases were correctly classified as 'at risk for melanoma' in the Italian and in the Brazilian populations, respectively. The risk model is a simple tool that identifies patients for preventive measures and may be used with reasonable confidence in different populations. The risk model may help family doctors in referring patients to dermatological clinics and thus improve early diagnosis.
Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy. c.fortes@idi.it
Cristina
C
Fortes
Simona
S
Mastroeni
Lucio
L
Bakos
Gianluca
G
Antonelli
Livia
L
Alessandroni
Maria Antonietta
MA
Pilla
Massimo
M
Alotto
Alba
A
Zappalà
Thomas
T
Manoorannparampill
Renan
R
Bonamigo
Paolo
P
Pasquini
Franco
F
Melchi
D019540:Area Under Curve; D001938:Brazil; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008545:Melanoma / Q000517:prevention & control*; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D015233:Models, Statistical; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000517:prevention & control*