Using an electronic self-completion tool to identify patients at increased risk of melanoma in Australian primary care.
BACKGROUND/OBJECTIVES
Some international guidelines recommend a risk-based approach to screening for melanoma, but few suggest how to account for multiple risk factors or how to implement risk-based screening in practice. This study investigated the acceptability and feasibility of identifying patients at increased risk of melanoma in Australian general practice using a self-completed risk assessment tool. Stratification of risk was based on the validated Williams melanoma risk prediction model.


METHODS
Patients and companions aged 18 or older in Australian general practices were approached in the waiting room and invited to enter information about their melanoma risk factors into the tool using an iPad. Acceptability was measured by the proportion of people willing to participate from those invited and feasibility by the number of people able to complete the tool unaided. Risk of developing melanoma was stratified into four risk categories using the Williams model.


RESULTS
1535 (90.4%) participants were recruited from two general practices. Only 200 participants (13%) needed assistance to complete the tool. The mean risk score for participants was 15.2 (±SD 9.8). The Williams model estimated between 5% and 19% of the sample were at increased risk accounting for an estimated 30% to 60% of future incident melanomas.


CONCLUSIONS
A risk-stratified tool using the Williams model was acceptable and feasible for patients to self-complete in general practice clinics. This could be an effective way to identify people in primary care for implementing risk-based targeted melanoma screening and prevention.
['Habgood|Emily|E|https://orcid.org/0000-0002-5438-2986', 'Walter|Fiona M|FM|https://orcid.org/0000-0002-7191-6476', "O'Hare|Erin|E|", 'McIntosh|Jennifer|J|https://orcid.org/0000-0002-6655-0940', 'McCormack|Chris|C|https://orcid.org/0000-0002-9567-3122', 'Emery|Jon D|JD|https://orcid.org/0000-0002-5274-6336']
D000293:Adolescent D000328:Adult D000368:Aged D001315:Australia D003197:Computer Literacy D034201:Computers, Handheld D005240:Feasibility Studies D005260:Female D006801:Humans D008297:Male D008545:Melanoma D008875:Middle Aged D010358:Patient Participation D011320:Primary Health Care D018570:Risk Assessment D012307:Risk Factors D057566:Self Report D012878:Skin Neoplasms D055815:Young Adult
melanoma primary care screening risk assessment