title: Identifying people at higher risk of melanoma across the U.K.: a primary-care-based electronic survey.
abstract: BACKGROUND
  Melanoma incidence is rising rapidly worldwide among white populations. Defining higher-risk populations using risk prediction models may help targeted screening and early detection approaches.
  
  
  OBJECTIVE
  To assess the feasibility of identifying people at higher risk of melanoma using the Williams self-assessed clinical risk estimation model in U.K. primary care.
  
  
  METHODS
  We recruited participants from the waiting rooms of 22 general practices covering a total population of > 240 000 in three U.K. regions: Eastern England, North East Scotland and North Wales. Participants completed an electronic questionnaire using tablet computers. The main outcome was the mean melanoma risk score using the Williams melanoma risk model.
  
  
  RESULTS
  Of 9004 people approached, 7742 (86%) completed the electronic questionnaire. The mean melanoma risk score for the 7566 eligible participants was 17·15 ± 8·51, with small regional differences [lower in England compared with Scotland (P = 0·001) and Wales (P < 0·001), mainly due to greater freckling and childhood sunburn among Scottish and Welsh participants]. After weighting to the age and sex distribution, different potential cut-offs would allow between 4% and 20% of the population to be identified as higher risk, and those groups would contain 30% and 60%, respectively of those likely to develop melanoma.
  
  
  CONCLUSIONS
  Collecting data on the melanoma risk profile of the general population in U.K. primary care is both feasible and acceptable for patients in a general practice setting, and provides opportunities for new methods of real-time risk assessment and risk stratified cancer interventions.
authors.affiliation: Primary Care Unit, Department of Public Health & Primary Care, University of Cambridge School of Clinical Medicine, Strangeways Research Laboratory, Cambridge, CB1 8RN, U.K.
authors.forename: J A
authors.initials: JA
authors.lastname: Usher-Smith
authors.affiliation: Department of Applied Health Research, University College London, London, U.K.
authors.forename: A P
authors.initials: AP
authors.lastname: Kassianos
authors.affiliation: Department of General Practice, Melbourne Medical School Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Carlton, Victoria, Australia.
authors.forename: J D
authors.initials: JD
authors.lastname: Emery
authors.affiliation: Primary Care Unit, Department of Public Health & Primary Care, University of Cambridge School of Clinical Medicine, Strangeways Research Laboratory, Cambridge, CB1 8RN, U.K.
authors.forename: G A
authors.initials: GA
authors.lastname: Abel
authors.affiliation: Betsi Cadwaladr University Health Board, Wrexham Maelor Hospital, Wrexham, U.K.
authors.forename: Z
authors.initials: Z
authors.lastname: Teoh
authors.affiliation: Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, U.K.
authors.forename: S
authors.initials: S
authors.lastname: Hall
authors.affiliation: North Wales Centre for Primary Care Research, Bangor University, Wrexham, U.K.
authors.forename: R D
authors.initials: RD
authors.lastname: Neal
authors.affiliation: Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, U.K.
authors.forename: P
authors.initials: P
authors.lastname: Murchie
authors.affiliation: Primary Care Unit, Department of Public Health & Primary Care, University of Cambridge School of Clinical Medicine, Strangeways Research Laboratory, Cambridge, CB1 8RN, U.K.
authors.forename: F M
authors.initials: FM
authors.lastname: Walter
mesh_terms: D000328:Adult; D000368:Aged; D055088:Early Detection of Cancer / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D058006:General Practice / Q000592:standards; D006200:Hair Color; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000453:epidemiology; D008548:Melanosis / Q000175:diagnosis / Q000453:epidemiology; D008875:Middle Aged; D012111:Residence Characteristics / Q000706:statistics & numerical data; D018570:Risk Assessment / Q000379:methods; D012423:Rural Health / Q000706:statistics & numerical data; D017678:Sex Distribution; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D013471:Sunburn / Q000175:diagnosis / Q000453:epidemiology; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology; D014504:Urban Health / Q000706:statistics & numerical data; D055815:Young Adult