Skin Surveillance Can Be Tailored To Individuals at Higher Risk of Melanoma Interview with:

Caroline Watts| Research Fellow

Dr. Caroline Watts

Caroline Watts | Research Fellow
Cancer Epidemiology and Prevention Research
Sydney School of Public Health
Melanoma Institute Australia (MIA) investigator
The University of Sydney What is the background for this study? What are the main findings?

Response: The Melanoma Patterns of Care study was a population-based observational study of physicians’ reported clinical management of 2727 patients diagnosed with an in situ or invasive primary melanoma over a 12-month period from October 2006 to 2007 in New South Wales, Australia. This paper investigated the differences between 1052 (39%) patients who were defined as higher risk owing to a family history of melanoma, multiple primary melanomas, or many nevi (moles) compared to patients who did not have any risk factors.

We found that the higher-risk group had a younger mean age at diagnosis compared to those without risk factors, (62 vs 65 years, P < .001) which varied by type of risk factor (56 years for patients with a family history, 59 years for those with many nevi, and 69 years for those with a previous melanoma). These age differences were consistent across all body sites. Among higher-risk patients, those with many nevi were more likely to have melanoma on the trunk (41% vs 29%, P < .001), those with a family history of melanoma were more likely to have melanomas on the limbs (57%vs 42%, P < .001), and those with a personal history were more likely to have melanoma on the head and neck (21% vs 15%, P < .001). What should readers take away from your report?

Response: The results of our study suggest that a person’s risk factor status might be used to tailor their surveillance program in terms of starting age and education about skin self-examination or more intensive surveillance. For instance, doctors could encourage people with many moles or with a family history of melanoma to start skin self-examination and monitoring at an earlier age than other people, and discuss the body sites that require particular attention. What recommendations do you have for future research as a result of this study?

Response: Future research could focus on how clinicians could better identify patients at higher risk and practical ways to tailor ongoing surveillance. Risk prediction models require validation and piloting on different platforms but could potentially assist clinicians in identifying patients who require closer surveillance. Examining how patients can be best educated about self-examination will also have most benefit for those at highest risk of subsequent melanoma. Thank you for your contribution to the community.


Watts CG, Madronio C, Morton RL, Goumas C, Armstrong BK, Curtin A, Menzies SW, Mann GJ, Thompson JF, Cust AE. Clinical Features Associated With Individuals at Higher Risk of MelanomaA Population-Based Study. JAMA Dermatol. Published online November 09, 2016. doi:10.1001/jamadermatol.2016.3327

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on November 10, 2016 by Marie Benz MD FAAD