Abstract
OBJECTIVE: To develop a self-assessed melanoma risk score to identify high-risk persons for screening METHODS: We used data from a 1997 melanoma case-control study from Washington State, USA, where 386 cases with invasive cutaneous melanoma and 727 controls were interviewed by telephone. A logistic regression prediction model was developed on 75% of the data and validated in the remaining 25% by calculating the area under the receiver operating characteristic curve (AUC), a measure of predictive accuracy from 0.5-1 (higher scores indicating better prediction). A risk score was calculated for each individual, and sensitivities for various risk cutoffs were calculated. RESULTS: The final model included sex, age, hair color, density of freckles, number of severe sunburns in childhood and adolescence, number of raised moles on the arms, and history of non-melanoma skin cancer. The area under the receiver operating characteristic curve(AUC) was 0.70 (95% CI: 0.64, 0.77). The top 15% risk group included 50% of melanomas (sensitivity 50%). CONCLUSIONS: This self-assessed score could be used as part of a comprehensive melanoma screening and public education program to identify high-risk individuals in the general population. This study suggests it may be possible to capture a large proportion of melanomas by screening a small high-risk group. Further study is needed to determine the costs, feasibility, and risks of this approach.
Highlights
Obesity is considered a global concern throughout the Western world, due to its increasing prevalence
It is well established that the occurrence of poor weight status in both children and youths appears to be increasing for all ages with recent findings suggesting that the prevalence of obesity in 6 to 11 year olds increasing from 6.5% in the 1980s to approximately 20% in 2008 [1,2]
It is well established that cardiovascular disease has its origins in childhood with high levels of adiposity often associated with an increased risk of adult obesity, and with a number of immediate health risks that can be associated with cardiovascular disease, such as hypertension [3,4]
Summary
Obesity is considered a global concern throughout the Western world, due to its increasing prevalence. It is well established that cardiovascular disease has its origins in childhood with high levels of adiposity often associated with an increased risk of adult obesity, and with a number of immediate health risks that can be associated with cardiovascular disease, such as hypertension [3,4] For this reason it has become vital to recognise children with a high risk at the earliest opportunity, so that an intervention programme can be put in place to prevent later onset of adverse health profiles. Recent findings published in Scotland portray a worrying figure, with approximately one in three (35%) of Scottish adolescences aged 2 to 15 years of age apparently unable or unwilling to achieve the minimal activity guidelines [11] These findings are worrying due to the well-established associations between physical inactivity and being overweight and obese [12,13]. Since risk factors often track from adolescence into adulthood, information detailing the associations between weight status and physical fitness is potentially relevant to the development and implementation of preventive measures and effective intervention strategies
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