{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T13:00:46Z","timestamp":1781528446466,"version":"3.54.1"},"reference-count":56,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Dermatol"],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"\n Importance<\/jats:title>\n The MEL-SELF randomized clinical trial (RCT) evaluated patient-led surveillance as an alternative model of follow-up. The baseline characteristics of participants provide insights into current unmet clinical needs of this population.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To describe the baseline characteristics of people screened for and randomized to the MEL-SELF RCT, and those potentially eligible but not randomized.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n \n Baseline data from the RCT\u2019s recruitment processes, from December 2021 to June 2024, were analyzed. Data were collected from dermatologist- and general practitioner\u2013led skin cancer clinics in Australia, and included adults previously treated for early-stage melanoma (by\n American Joint Committee on Cancer Staging Manual<\/jats:italic>\n [\n AJCC,<\/jats:italic>\n 0-II]) attending routinely scheduled clinics, with a skin self-examination (SSE) partner, and a smartphone. Analysis took place between August 2025 and December 2025.\n <\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Participants were invited to participate in the MEL-SELF trial with randomization (1:1) to patient-led surveillance (usual care plus reminders to perform SSE, mobile dermatoscope, teledermatologist assessment, fast-tracked unscheduled clinic visits) or clinician-led surveillance (usual care) for 12 months.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The main outcomes were enrollment; active run-in and allocation results, sociodemographic and clinical characteristics; SSE knowledge, attitudes, and practice (frequency and thoroughness); and psychological measures including fear of cancer recurrence (FCR) at baseline.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of 1226 patients screened and potentially eligible, 504 were randomized to patient-led (n\u2009=\u2009251) or clinician-led (n\u2009=\u2009253) surveillance. Overall, 295 were female individuals (59%) and 209 were male individuals (41%), most were aged 50 years and older (mean [SD] age, 56.0 [11.6] years) and had a highest substage of melanoma in situ (245 [49%]) or IA (217 [43%]). SSE practice varied substantially, ranging from no SSE in the previous 12 months (103 [20%]) to weekly or monthly SSE (160 [32%]). A high proportion (232 [46%]) reported clinically significant levels of FCR, which was associated with being female, younger age, and higher depression, anxiety, and stress scores. FCR was associated with a higher perceived lifetime risk of melanoma, but not with participants\u2019 actual calculated risk of a subsequent new primary melanoma (OR, 1.00; 95% CI, 0.99-1.01). Characteristics were similar between the trial population and potentially eligible patients who completed the baseline questionnaire but were not randomized (n\u2009=\u2009225).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This secondary analysis of baseline characteristics in the MEL-SELF trial indicates suboptimal SSE practice and clinically significant levels of FCR. Future reports will evaluate comparative effects of patient-led surveillance on health, psychological and health resource use outcomes.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n anzctr.org.au<\/jats:ext-link>\n Identifier:\n ACTRN12621000176864<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamadermatol.2026.0083","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T15:00:46Z","timestamp":1773241246000},"page":"457","source":"Crossref","is-referenced-by-count":2,"title":["Characteristics of Participants Screened and Randomized to the Melanoma Self Surveillance Trial"],"prefix":"10.1001","volume":"162","author":[{"given":"Ellie","family":"Medcalf","sequence":"first","affiliation":[{"name":"Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deonna M.","family":"Ackermann","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jake T. W.","family":"Williams","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia"},{"name":"Heat and Health Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin M.","family":"Turner","sequence":"additional","affiliation":[{"name":"Biostatistics Centre, University of Otago, Dunedin, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Espinoza","sequence":"additional","affiliation":[{"name":"National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuohan","family":"Wu","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Fann","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priti","family":"Kharel","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Janda","sequence":"additional","affiliation":[{"name":"Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne E.","family":"Cust","sequence":"additional","affiliation":[{"name":"The Daffodil Centre, The University of Sydney, Sydney, New South Wales, Australia"},{"name":"Cancer Council NSW, Sydney, New South Wales, Australia"},{"name":"Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Les","family":"Irwig","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolyn K.","family":"Hersch","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald","family":"Low","sequence":"additional","affiliation":[{"name":"Cancer Voices New South Wales, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"Low","sequence":"additional","affiliation":[{"name":"Cancer Voices New South Wales, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascale","family":"Guitera","sequence":"additional","affiliation":[{"name":"Melanoma Institute Australia, Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia"},{"name":"Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda K.","family":"Martin","sequence":"additional","affiliation":[{"name":"Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. Peter","family":"Soyer","sequence":"additional","affiliation":[{"name":"Frazer Institute, Dermatology Research Centre, The University of Queensland, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Azzi","sequence":"additional","affiliation":[{"name":"Newcastle Skin Check, Newcastle, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alister","family":"Lilleyman","sequence":"additional","affiliation":[{"name":"Newcastle Skin Check, Newcastle, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Rosengren","sequence":"additional","affiliation":[{"name":"Skin Repair Skin Cancer Clinic, Townsville, Australia"},{"name":"College of Medicine and Dentistry, James Cook University, Townsville, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Mar","sequence":"additional","affiliation":[{"name":"Victorian Melanoma Service, Alfred Health, Melbourne, Victoria, Australia"},{"name":"School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle Y.","family":"Mcrae","sequence":"additional","affiliation":[{"name":"Pinnacle Dermatology, Orange, Australia"},{"name":"The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Glanz","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"},{"name":"Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Camperdown, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Collgros","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"},{"name":"Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Camperdown, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon D.","family":"Emery","sequence":"additional","affiliation":[{"name":"Population and Global Health, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore"},{"name":"Department of General Practice and Primary care and Centre for Cancer Research, The University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Murchie","sequence":"additional","affiliation":[{"name":"Academic Primary Care, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachael L.","family":"Morton","sequence":"additional","affiliation":[{"name":"National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Ferguson","sequence":"additional","affiliation":[{"name":"Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia"},{"name":"Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"},{"name":"Tissue Pathology and Diagnostic Oncology, The Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catriona","family":"McLean","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology, Alfred Hospital, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katy J. 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