OBJECTIVES: Self-examination of the skin has been associated with a reduced risk of advanced melanoma, but self-assessment has corresponded imperfectly with clinical examination by a dermatologist, and shown only moderate accuracy in identifying individuals at risk. STUDY DESIGN: Population-based screening campaign in Styria, Austria. METHODS: One thousand two hundred and twenty-three Caucasians volunteered for a free skin assessment by a dermatologist. First, they answered a questionnaire in which they assessed their own melanoma risk factors, and they were subsequently examined by a dermatologist. Kappa agreements between the two assessments were calculated. RESULTS: The overall kappa agreements on the estimated number of naevi, the assessment of skin phototype and the perception of increased melanoma risk were 0.34 [95% confidence interval (CI) 0.30-0.37], 0.28 (95%CI 0.24-0.32) and 0.24 (95% CI 0.18-0.30), respectively. Kappa agreements below 0.40 are considered poor. Stratification by age and gender revealed slightly higher scores for subgroups on single items. CONCLUSIONS: Screening for melanoma should be population based and should not be limited to self-referrals since self-assessment for melanoma risk factors is inaccurate. Educational programmes must be developed to improve self-assessment and to target populations at risk.
OBJECTIVES: Self-examination of the skin has been associated with a reduced risk of advanced melanoma, but self-assessment has corresponded imperfectly with clinical examination by a dermatologist, and shown only moderate accuracy in identifying individuals at risk. STUDY DESIGN: Population-based screening campaign in Styria, Austria. METHODS: One thousand two hundred and twenty-three Caucasians volunteered for a free skin assessment by a dermatologist. First, they answered a questionnaire in which they assessed their own melanoma risk factors, and they were subsequently examined by a dermatologist. Kappa agreements between the two assessments were calculated. RESULTS: The overall kappa agreements on the estimated number of naevi, the assessment of skin phototype and the perception of increased melanoma risk were 0.34 [95% confidence interval (CI) 0.30-0.37], 0.28 (95%CI 0.24-0.32) and 0.24 (95% CI 0.18-0.30), respectively. Kappa agreements below 0.40 are considered poor. Stratification by age and gender revealed slightly higher scores for subgroups on single items. CONCLUSIONS: Screening for melanoma should be population based and should not be limited to self-referrals since self-assessment for melanoma risk factors is inaccurate. Educational programmes must be developed to improve self-assessment and to target populations at risk.
Authors: Anne E Cust; Kristen M Pickles; Chris Goumas; Thao Vu; Helen Schmid; Eduardo Nagore; John Kelly; Joanne F Aitken; Graham G Giles; John L Hopper; Mark A Jenkins; Graham J Mann Journal: Cancer Epidemiol Biomarkers Prev Date: 2015-01-27 Impact factor: 4.254