Objective: To compare during the first 12 months of a 3-year randomised community-based trial of population screening for melanoma three methods of screening delivery: skin screening within day-to-day primary care (Group A); screening in dedicated skin screening clinics either organised privately by local physicians (Group B); or organised centrally with participants referred back to their physicians for definitive diagnosis and management (Group C). Methods: The trial involved 18 regional communities in Queensland, Australia. Of the nine communities randomised to the intervention group, three communities were allocated to each of the Groups A, B or C. All intervention communities received a community education programme and an education and support programme for primary care physicians. The self-reported prevalence of clinical skin examination was assessed by surveying 3,110 residents (66.9% participation rate) aged ≥30 years by telephone at baseline, and 14,060 residents (70.9% participation rate) by self-administered mailed questionnaire at 12-month follow-up. Results: At baseline the prevalence of skin screening did not differ between intervention and control communities. At 12-month follow-up, participants within intervention communities reported skin screening significantly more frequently (20.9% versus 10.9%; p less than 0.001). Within intervention communities, the prevalence of clinical skin examinations in Group A was similar to that of control communities (12.6% and 10.9%; p = 0.33). Communities in Group B (16.5%; p = 0.001) and Group C (27.1%; p less than 0.001) reported significantly higher prevalence of clinical examinations than the control group. Conclusions: The provision of centrally organised skin screening clinics significantly increases skin screening rates and may have relevance for future melanoma control programmes.
Cancer Causes and Control / Vol. 17, no. 2, pp.161-168