Abstract
The rising incidence of cutaneous melanoma over the past few decades has prompted substantial efforts to develop risk prediction models identifying people at high risk of developing melanoma to facilitate targeted screening programs. We review these models, regarding study characteristics, differences in risk factor selection and assessment, evaluation, and validation methods. Our systematic literature search revealed 40 studies comprising 46 different risk prediction models eligible for the review. Altogether, 35 different risk factors were part of the models with nevi being the most common one (n = 35, 78%); little consistency in other risk factors was observed. Results of an internal validation were reported for less than half of the studies (n = 18, 45%), and only 6 performed external validation. In terms of model performance, 29 studies assessed the discriminative ability of their models; other performance measures, e.g., regarding calibration or clinical usefulness, were rarely reported. Due to the substantial heterogeneity in risk factor selection and assessment as well as methodologic aspects of model development, direct comparisons between models are hardly possible. Uniform methodologic standards for the development and validation of risk prediction models for melanoma and reporting standards for the accompanying publications are necessary and need to be obligatory for that reason.
Highlights
Cutaneous melanoma is one of the most lethal forms of skin cancer and accounts for the majority of skin cancer deaths [1]
As we focus on the prediction of new cases instead of the recurrence of melanoma, we concentrated on models for primary cutaneous melanoma
This systematic review shows that an abundance of melanoma risk prediction models were developed over the last decades, which has already been indicated by the systematic reviews of
Summary
Cutaneous melanoma is one of the most lethal forms of skin cancer and accounts for the majority of skin cancer deaths [1]. Over the past few decades, the incidence of melanoma has risen dramatically worldwide, especially in regions with fair-skinned populations [1,2,3]. While in many European populations, like the UK and the Netherlands, incidence rates increased with estimated annual percentage changes of 4 to 6% event in recent decades, the annual increase in incidence in Australia and. New Zealand seems to have leveled off since 1995 [4]. Australia and New Zealand have the highest incidence rates worldwide, followed by Western Europe, Northern Europe, and the USA [1,3,4]. In 2018, melanoma was the fourth most common cancer in Australia regarding incidence [5]. In Europe (except Southern Europe) and the USA, it ranks fifth and sixth [5]
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