Project 125: Student Project – Risk Factors for Melanoma in Tasmanian population: Can targeted screening be achieved?

01 Jan 2014

2014 Honours scholarship was awarded to Isabel Illingworth.

This project examined behavioural and physical characteristics of people with melanoma compared to those without to determine risk factors for melanoma. 100 people with melanoma will be recruited to attend a research clinic as will 500 people from the Tasmanian community without melanoma. Both groups will be asked a series of questions (eg. previous sunburn and sunbaking history) and have a thorough general and skin examination. Isabel’s project reported that Melanoma is common type of cancer in Australia which if identified in earlier stages is associated with less depth of invasion of lower mortality. This makes it an important public health consideration with regard to prevention and early detection. Whilst whole of population based screening is not currently recommended due to lack of feasibility and effectiveness, targeted screening of high risk individuals may be useful.

With this in mind we aimed to identify characteristics of people in Tasmania at high risk of melanoma, confirm known risks factors (and determine their importance in the Tasmanian population) as well as identify potential new risk factors. The aim was to then translate these factors into a risk assessment model to help identify those at high risk of melanoma. To do this we recruited 103 people with melanoma and 251 without. Each person filled out a questionnaire about skin and general health measures and had a skin examination. This allowed us to perform statistical analysis in order to determine the key differences between people with melanoma and people without. Final factors that were included in the risk assessment model included: moles >100, moles 20-100, severe freckling, past history of non-melanoma skin cancer, dark- brown eye colour, Fitzpatrick skin type II, no exercise, age, moderate to severe solar keratosis, past history of a ‘a lot of’ sunburns an past history of a ‘few’ sunburns. Using these factors we were able to determine an appropriate cut off point to determine whether individuals were high or low risk for melanoma (with sensitivity of 81.6% and specificity of 70.9%). We hope that through using this model, people would be able to be correctly identified as high –risk individuals for more frequent skin check and as such there is the potential to detect melanoma at an earlier stage.