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Melanoma Risk Assessment: Patient-Centric Surveillance Study

February, 02, 2024 | Melanoma, Skin Cancer

KEY TAKEAWAYS

  • The study aimed to investigate the feasibility and efficacy of integrating melanoma risk assessment into skin cancer care provision.
  • Researchers concluded that integrating personalized melanoma risk assessment and tailored surveillance into routine clinical care is feasible and well-received by patients.

While international organizations advocate for the integration of melanoma risk assessment into skin cancer care, there is a scarcity of evidence supporting its implementation.

A. L. Smith and his team assessed that international bodies recommend the integration of melanoma risk assessment into skin cancer care provision, yet evidence supporting implementation is lacking.

They performed an inclusive analysis, employing the Theoretical Framework of Acceptability (TFA) for guidance in this prospective qualitative implementation study. The study unfolded at the Melanoma Institute Australia, Sydney, Australia, where personalized, systematic melanoma risk assessment was introduced in the dermatology clinic from February to May 2021. The method involved pre- and post-implementation observations and semi-structured interviews with patients and staff, conducted between September 2020 and March 2021. Observational notes and interview transcript data underwent thematic analysis, utilizing the TFA as a classifying framework.

With 37 hours of observations and interviews of 29 patients and 12 clinic staff revealed that the introduction of personalized melanoma risk estimates had no discernible impact on patient flow through the clinic. Dermatologists expressed that the personalized risk information bolstered their confidence in assessing patient risk and recommending tailored surveillance schedules. 

Notably, most patients perceived the risk assessment and tailored information as a valuable addition to their care. However, among patients whose risk assessment deviated from their expectations, a subset reported experiencing feelings of worry, confusion, or mistrust in the provided risk information. This was particularly evident in cases where individuals at lower risk were recommended to decrease surveillance frequency. 

The study concluded that incorporating personalized melanoma risk information and tailored surveillance into routine clinical care within dermatology clinics is both feasible and well-received by patients and clinic staff, highlighting the potential for enhanced risk assessment strategies in skin cancer care provision.

The study is sponsored by NHMRC and Sydney Catalyst Translational Cancer Research Centre.

Source: https://pubmed.ncbi.nlm.nih.gov/38379327/

Smith AL, Smit AK, Laginha BI, et.al (2024). Implementing systematic melanoma risk assessment and risk-tailored surveillance in a skin cancer focussed dermatology clinic: A qualitative study of feasibility and acceptability to patients and clinic staff. Cancer Med. 2024 Jan;13(2):e6976. doi: 10.1002/cam4.6976. PMID: 38379327; PMCID: PMC10839129.

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