title: Accuracy of self-reported nevus and pigmentation phenotype compared with clinical assessment in a population-based study of young Australian adults.
abstract: BACKGROUND
  Awareness of individual risk may encourage improved prevention and early detection of melanoma.
  
  
  METHODS
  We evaluated the accuracy of self-reported pigmentation and nevus phenotype compared with clinical assessment, and examined agreement between nevus counts from selected anatomical regions. The sample included 456 cases with invasive cutaneous melanoma diagnosed between ages 18 to 39 years and 538 controls from the population-based Australian Melanoma Family Study. Participants completed a questionnaire about their pigmentation and nevus phenotype, and attended a dermatologic skin examination.
  
  
  RESULTS
  There was strong agreement between self-reported and clinical assessment of eye color [κ, = 0.78; 95% confidence interval (CI), 0.74-0.81]; and moderate agreement for hair color (κ = 0.46; 95% CI, 0.42-0.50). Agreement between self-reported skin color and spectrophotometer-derived measurements was poor (κ = 0.12; 95% CI, 0.08-0.16) to moderate (Spearman correlation rs = -0.37; 95% CI, -0.32 to -0.42). Participants tended to underestimate their nevus counts and pigmentation; men were more likely to underreport their skin color. The rs was 0.43 (95% CI, 0.38-0.49) comparing clinical total body nevus counts with self-reported nevus categories. There was good agreement between total body nevus counts and site-specific nevus counts, particularly on both arms.
  
  
  CONCLUSIONS
  Young adults have suboptimal accuracy when assessing important risk characteristics including nevus numbers and pigmentation. Measuring nevus count on the arms is a good predictor of full body nevus count.
  
  
  CONCLUSIONS
  These results have implications for the likely success of targeted public health programs that rely on self-assessment of these factors.
authors: Cancer Epidemiology and Services Research (CESR), Sydney School of Public Health, The University of Sydney, Sydney, Australia. anne.cust@sydney.edu.au.
authors: Anne E
authors: AE
authors: Cust
authors: Sydney School of Public Health, The University of Sydney, Sydney, Australia.
authors: Kristen M
authors: KM
authors: Pickles
authors: Cancer Epidemiology and Services Research (CESR), Sydney School of Public Health, The University of Sydney, Sydney, Australia.
authors: Chris
authors: C
authors: Goumas
authors: Cancer Epidemiology and Services Research (CESR), Sydney School of Public Health, The University of Sydney, Sydney, Australia.
authors: Thao
authors: T
authors: Vu
authors: Centre for Cancer Research, University of Sydney at Westmead Millennium Institute for Medical Research and Melanoma Institute Australia, Sydney, Australia.
authors: Helen
authors: H
authors: Schmid
authors: Department of Dermatology, Instituto Valenciano de Oncologia, Valencia, Spain.
authors: Eduardo
authors: E
authors: Nagore
authors: Victorian Melanoma Service, Alfred Hospital, Melbourne, Australia.
authors: John
authors: J
authors: Kelly
authors: Viertel Centre for Research in Cancer Control, Cancer Council Queensland, Spring Hill, Brisbane, Australia.
authors: Joanne F
authors: JF
authors: Aitken
authors: Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia. Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia.
authors: Graham G
authors: GG
authors: Giles
authors: Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
authors: John L
authors: JL
authors: Hopper
authors: Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
authors: Mark A
authors: MA
authors: Jenkins
authors: Centre for Cancer Research, University of Sydney at Westmead Millennium Institute for Medical Research and Melanoma Institute Australia, Sydney, Australia.
authors: Graham J
authors: GJ
authors: Mann
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia; D016022:Case-Control Studies; D005127:Eye Color / Q000502:physiology; D005260:Female; D006200:Hair Color / Q000502:physiology; D006801:Humans; D008297:Male; D009508:Nevus, Pigmented / Q000175:diagnosis*; D010641:Phenotype; D015203:Reproducibility of Results; D057566:Self Report; D012878:Skin Neoplasms / Q000175:diagnosis*; D012880:Skin Pigmentation; D011795:Surveys and Questionnaires; D055815:Young Adult
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