Online melanoma test accurately predicts the risk of developing cancer

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Researchers at the QIMR Berghofer Medical Research Institute have developed an online skin cancer test that can identify people at high risk of melanoma in 90 seconds. The free test is available online.

The test predicts the likelihood of developing the disease over the next three-and-a-half years, based on seven risk factors: age, sex, ability to tan, number of moles at age 21, number of skin lesions treated, hair colour and sunscreen use. The QIMR team, led by researcher Professor David Whiteman and Dr Catherine Olsen, determined the seven risk factors by following around 42,000 Queenslanders over eight years, in the world’s largest study of skin cancer. The team’s research paper on the process is published in the Journal of the National Cancer Institute, available on CKN. 

"This test is the most robust instrument we have ever been able to develop for predicting risk of melanoma," Professor Whiteman said. "The tool is very self-explanatory and easy to use. So for instance, reporting the number of moles you have on your skin — there are pictures of people with moles on their skin, so you pick the one closest to you. You do not have to have any detailed knowledge at all, they are quite simple questions to answer."

The seven risk factors are each weighted differently. The tool’s algorithm uses these to assign a person into one of five risk categories: very much below average, below average, average, above average, and very much above average. After completing the short test, users will be offered advice, such as whether they should see their doctor to explore possible options for managing their melanoma risk.

“Last year a QIMR Berghofer study found that melanoma cost the Australian healthcare system $201 million in 2017,” Professor Whiteman said. “We hope that by identifying those who might benefit from regular skin checks, the online melanoma risk predictor will help to ease pressure on the healthcare system.”

Other melanoma risk predictors have previously been developed, however they were based on research with different study designs and were less accurate. The QIMR team say that they have tested the online risk predictor thoroughly and found that it is accurate at predicting a person’s risk of developing melanoma.

“We encourage people to use it as a general guide, and if it says you have a high risk of melanoma, we strongly encourage you to visit your doctor and discuss whether a skin check would benefit you. Even if you have a low to medium risk, you still need to be sun safe. Most Australians are at a higher risk of melanoma than people in other countries due to the combined effects of fair skin and very high levels of sunlight.

“At the moment, cancer control agencies don’t recommend population-wide screening programs for melanoma. It’s up to individuals to talk to their doctors about whether they need regular skin checks,” Professor Whiteman said.

“This online risk predictor will help identify those people with the highest likelihood of developing melanoma so that they and their doctors can decide how to best manage their risk. Regular screening of those at highest risk may help to detect melanomas early, and hopefully before they’ve spread to the lower layers of the skin and other parts of the body. Importantly, in this study, we found that people’s actual risk of melanoma was quite different to their own assessment. This highlights the importance of getting personalised advice on melanoma risk, because it could well be different to perceived risk.”

Professor Whiteman said the team now planned to trial the online melanoma risk predictor among skin cancer doctors and their patients to test how it performs in the clinic.

The test is aimed at people aged 40 and above; the age range of the cohort studied. However, melanoma remains the most common cancer in Australians under 40, and the fourth most common cancer nationally. Cancer Australia predicts that this year 1,905 people will die from melanoma and approximately one in 17 Australians will be diagnosed with melanoma by their 85th birthday.

Professor Whiteman said “I don’t think it’s possible that we’ll ever get to 100%. I think that’s a holy grail that we aspire to, but in reality, cancers are very complex diseases and their causality includes many, many, factors, including unfortunately some random factors.”

Melanoma Resources on CKN