title: Development and validation of a melanoma risk score based on pooled data from 16 case-control studies.
abstract: BACKGROUND
  We report the development of a cutaneous melanoma risk algorithm based upon seven factors; hair color, skin type, family history, freckling, nevus count, number of large nevi, and history of sunburn, intended to form the basis of a self-assessment Web tool for the general public.
  
  
  METHODS
  Predicted odds of melanoma were estimated by analyzing a pooled dataset from 16 case-control studies using logistic random coefficients models. Risk categories were defined based on the distribution of the predicted odds in the controls from these studies. Imputation was used to estimate missing data in the pooled datasets. The 30th, 60th, and 90th centiles were used to distribute individuals into four risk groups for their age, sex, and geographic location. Cross-validation was used to test the robustness of the thresholds for each group by leaving out each study one by one. Performance of the model was assessed in an independent UK case-control study dataset.
  
  
  RESULTS
  Cross-validation confirmed the robustness of the threshold estimates. Cases and controls were well discriminated in the independent dataset [area under the curve, 0.75; 95% confidence interval (CI), 0.73-0.78]. Twenty-nine percent of cases were in the highest risk group compared with 7% of controls, and 43% of controls were in the lowest risk group compared with 13% of cases.
  
  
  CONCLUSIONS
  We have identified a composite score representing an estimate of relative risk and successfully validated this score in an independent dataset.
  
  
  CONCLUSIONS
  This score may be a useful tool to inform members of the public about their melanoma risk.
authors.affiliation: Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, United Kingdom. J.R.Davies@leeds.ac.uk.
authors.forename: John R
authors.initials: JR
authors.lastname: Davies
authors.affiliation: Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, United Kingdom.
authors.forename: Yu-mei
authors.initials: YM
authors.lastname: Chang
authors.affiliation: Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, United Kingdom.
authors.forename: D Timothy
authors.initials: DT
authors.lastname: Bishop
authors.affiliation: Sax Institute and Sydney School of Public Health, The University of Sydney, Sydney, Australia.
authors.forename: Bruce K
authors.initials: BK
authors.lastname: Armstrong
authors.affiliation: Twin Research and Genetic Epidemiology Unit, St. Thomas' Campus, Kings College London, London, United Kingdom. Dermatology Department, West Herts NHS Trust, Hemel Hempstead General Hospital, Herts, United Kingdom.
authors.forename: Veronique
authors.initials: V
authors.lastname: Bataille
authors.affiliation: Department of Dermatology, Leiden University Medical Centre, Leiden, the Netherlands.
authors.forename: Wilma
authors.initials: W
authors.lastname: Bergman
authors.affiliation: Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico.
authors.forename: Marianne
authors.initials: M
authors.lastname: Berwick
authors.affiliation: Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California.
authors.forename: Paige M
authors.initials: PM
authors.lastname: Bracci
authors.affiliation: Department of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand.
authors.forename: J Mark
authors.initials: JM
authors.lastname: Elwood
authors.affiliation: Department of Medicine, Geisel School of Medicine and the Norris Cotton Cancer Center, Dartmouth University, Lebanon, New Hampshire.
authors.forename: Marc S
authors.initials: MS
authors.lastname: Ernstoff
authors.affiliation: Queensland Institute of Medical Research, PO Royal Brisbane Hospital, Brisbane, Australia.
authors.forename: Adele
authors.initials: A
authors.lastname: Green
authors.affiliation: Department of Dermatology, Leiden University Medical Centre, Leiden, the Netherlands.
authors.forename: Nelleke A
authors.initials: NA
authors.lastname: Gruis
authors.affiliation: Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Holly
authors.affiliation: Department of Surgery, University Hospital, Lund, Sweden.
authors.forename: Christian
authors.initials: C
authors.lastname: Ingvar
authors.affiliation: Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Kanetsky
authors.affiliation: Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Norris Cotton Cancer Center, Lebanon, New Hampshire.
authors.forename: Margaret R
authors.initials: MR
authors.lastname: Karagas
authors.affiliation: B.C. Cancer Research Centre, Vancouver, British Columbia, Canada.
authors.forename: Tim K
authors.initials: TK
authors.lastname: Lee
authors.affiliation: University of Hawaii Cancer Center, Honolulu, Hawaii.
authors.forename: Loïc
authors.initials: L
authors.lastname: Le Marchand
authors.affiliation: Department of Public Health and Health Policy, University of Glasgow, Glasgow, United Kingdom.
authors.forename: Rona M
authors.initials: RM
authors.lastname: Mackie
authors.affiliation: Department of Oncology, University Hospital, Lund, Sweden.
authors.forename: Håkan
authors.initials: H
authors.lastname: Olsson
authors.affiliation: Kobenhaausevej 35, Hillerød, Denmark.
authors.forename: Anne
authors.initials: A
authors.lastname: Østerlind
authors.affiliation: Department of Biostatistics and Epidemiology and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Rebbeck
authors.affiliation: Dermatologikum Hamburg, Hamburg, Germany.
authors.forename: Kristian
authors.initials: K
authors.lastname: Reich
authors.affiliation: Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine, London, United Kingdom.
authors.forename: Peter
authors.initials: P
authors.lastname: Sasieni
authors.affiliation: Queensland Institute of Medical Research, PO Royal Brisbane Hospital, Brisbane, Australia.
authors.forename: Victor
authors.initials: V
authors.lastname: Siskind
authors.affiliation: Division of Genetics and Epidemiology, Institute of Cancer Research, London, United Kingdom. Division of Breast Cancer Research, Institute of Cancer Research, London, United Kingdom.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Swerdlow
authors.affiliation: Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Norris Cotton Cancer Center, Lebanon, New Hampshire.
authors.forename: Linda
authors.initials: L
authors.lastname: Titus
authors.affiliation: Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Norris Cotton Cancer Center, Lebanon, New Hampshire.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Zens
authors.affiliation: Institute of Medical Biometry and Statistics, University of Lübeck, University Hospital Schleswig-Holstein, Campus Lübeck, Germany. Center for Clinical Trials, University of Lübeck, Lübeck, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Ziegler
authors.affiliation: B.C. Cancer Research Centre, Vancouver, British Columbia, Canada.
authors.forename: Richard P
authors.initials: RP
authors.lastname: Gallagher
authors.affiliation: Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, United Kingdom.
authors.forename: Jennifer H
authors.initials: JH
authors.lastname: Barrett
authors.affiliation: Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, United Kingdom.
authors.forename: Julia
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mesh_terms: D000465:Algorithms; D016022:Case-Control Studies; D006801:Humans; D008545:Melanoma / Q000453:epidemiology*; D012107:Research Design; D012307:Risk Factors; D012878:Skin Neoplasms / Q000453:epidemiology*