Melanoma risk assessment and risk-stratified melanoma screening and surveillance

Abstract

Melanoma remains a major public health challenge in Australia, which has one of the highest melanoma incidence rates worldwide. Despite this burden, there is currently insufficient evidence to support the implementation of an organised population-wide melanoma screening program. Early detection largely relies on opportunistic skin checks undertaken in clinical practice. Current clinical guidance recommends identifying individuals at higher personal risk and offering them more regular skin examinations, yet the consistency of this risk-based approach remains uncertain. This thesis examined how melanoma early detection currently operates in Australia and how risk prediction tools might support more consistent risk-based approaches in clinical practice and future screening policy. The research programme combined studies examining clinical skin check behaviours, the acceptability of melanoma risk prediction tools, and the performance of existing melanoma risk prediction models. This thesis provides new evidence relevant to both current clinical practice and ongoing considerations regarding melanoma screening policy in Australia.