MSCAN is proud to be part of the melanoma research led by QIMR Berghofer: testing whether receiving personalised genetic risk information can improve screening adherence for melanoma.

The skin check landscape is really confusing. We know that people with fair skin are at higher risk of skin cancer, but it’s confusing beyond that. There are no clear guidelines on who should have skin checks and how often they should get their skin checked.

MSCAN discusses the research underway with Matthew Law, Senior Research Officer at QIMR Berghofer.

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Cutaneous melanoma is common, deadly, and expensive, and Australia has the highest incidence of this disease world-wide.

Over 1,300 people died from melanoma in 2024. Early detection of melanoma is key to maximising survival from melanoma. Yet clinical skin screening of the entire population by a medical professional (e.g. a GP or a dermatologist) is not recommended for melanoma because there is insufficient evidence that the expenditure would yield a net benefit in terms of years of life saved and/or costly therapies averted. Further, nearly two melanomas in situ are detected in Australia for each invasive melanoma.¹

Melanoma in situ is localised to the surface of the skin (the epidermis) and is unlikely to progress and affect health. Half of the ~$400 million spent on melanoma in 2021 was due to melanoma in situ.²

Targeting clinical skin screening to those at a high-risk of melanoma resolves these problems. To address this, the Australian government has funded the development of a “National Roadmap for Melanoma Screening”, an initiative to explore risk-targeted and cost-effective melanoma screening.

It is unclear, though, what is the best way to encourage adherence to screening guidelines. A person is adherent to the current clinical skin check (screening) guidelines if:

(i) they are assessed as low risk and are not undergoing regular skin checks; or

(ii) they are assessed as high risk and are being screened.

The former – screening in low risk – is likely to be a particular problem, given the media coverage of the advantages of screening and the current high rate of ad hoc screening.

Based on the distribution of melanoma risk and rates of ad hoc screening within the QSkin Sun and Health Study (see below), we estimate that the prevalence of non-adherence is ~30%. Similar analyses in other Australian populations have found non-adherence may be even higher at 40%.³ Further, while those at higher risk tend to accept increasing screening frequency, people identified as ‘low-risk’ can be reluctant to reduce screening.³ Interestingly, at least in screening for breast cancer (rather than skin cancer), telling people their genetic risk may encourage adherence in those at low risk.⁴

The QSkin Study

The QSkin Study of Sun and Health is a large prospective cohort study led by QIMR Berghofer and is one of the largest research studies ever conducted on skin cancer. More than 43,000 Australians answered the baseline risk factor survey in 2010-11 and also gave their consent to be followed through medical records over time. Importantly, the QSkin study will provide long-term information about the burden of skin cancer in Australia. The study continues to provide valuable information on all the different ways in which skin cancers are treated in Australia. By comparing the information from people with and without skin cancer, we are also gaining a better understanding of how skin cancers develop.

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1. Australian Institute of Health and Welfare; Cancer Data in Australia 2024 [↩]
2. Gordon, L. G. et al. Int. J. Environ. Res. Public Health 19, (2022). [↩]
3. Perera, M. M. et al. Int. J. Cancer 155, 2058–2067 (2024). [↩] [↩]
4. Mbuya Bienge, C. et al. J. Pers. Med. 11, 95 (2021). [↩]