title: Validation of the Self-Assessment of Melanoma Risk Score for a melanoma-targeted screening.
abstract: Melanoma is nowadays a major public health problem because of its increasing incidence. Targeted screening for patients at a high risk for melanoma is being promoted. The aim of our study was to assess the effectiveness of a targeted screening on the basis of the self-selection of high-risk individuals with the Self-Assessment of Melanoma Risk Score (SAMScore). Our main objective was to prove that this score allows the selection of a group of patients who are at a higher risk and in whom more melanomas may be detected. This prospective study was carried out in France in 2009. Consecutive patients, while visiting their doctor's office, filled out a melanoma risk factor questionnaire. Patients were assessed as being at high risk or not according to the SAMScore, and patients at a high risk were examined both by their general practitioner and by a dermatologist. The efficiency of the selection tool corresponded to the ratio of the prevalence of melanoma in a population selected with the SAMScore to the prevalence in the general population. A logistic model with a random effect was used. A total of 7977 patients filled out the questionnaire. Among the 2404 patients at high risk, histologically proven melanoma was screened in 10 cases: two in-situ and eight invasive melanomas. The SAMScore efficiency assessed was equal to 11.54 (P=0.0016). In conclusion, in this strategy, to detect a new case of melanoma, it is necessary to screen 11 times fewer patients than with a nontargeted screening. This is the first study to confirm the efficiency of a targeted screening on the basis of self-selection of high-risk individuals.
authors.affiliation: Skin Cancer Unit, INSERM, 892, Nantes University Hospital, Nantes Cedex, France.
authors.forename: Gaëlle
authors.initials: G
authors.lastname: Quéreux
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: N'guyen
authors.forename: Myriam
authors.initials: M
authors.lastname: Cary
authors.forename: Olivier
authors.initials: O
authors.lastname: Jumbou
authors.forename: Yves
authors.initials: Y
authors.lastname: Lequeux
authors.forename: Brigitte
authors.initials: B
authors.lastname: Dréno
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055088:Early Detection of Cancer; D005240:Feasibility Studies; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000517:prevention & control; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012647:Self-Assessment; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D011795:Surveys and Questionnaires; D055815:Young Adult