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Of 2605 patients with localised melanoma, 1019 (39%) were defined as at higher risk due to the presence of one or more of the following factors: a family history of melanoma (11%), multiple primary melanomas (17%), or many naevi (24%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to patients at lower risk, high risk patients were more likely to receive their initial care from a primary care physician (56% <jats:italic>vs<\/jats:italic> 50%, <jats:italic>P<\/jats:italic> = 0.002), have their melanoma detected during a routine skin check (40% <jats:italic>vs<\/jats:italic> 33%, <jats:italic>P<\/jats:italic> &lt; 0.001), have their lesion assessed with dermoscopy (63% <jats:italic>vs<\/jats:italic> 56%, <jats:italic>P<\/jats:italic> = 0.002), and be encouraged to have skin surveillance (84% <jats:italic>vs<\/jats:italic> 77%, <jats:italic>P<\/jats:italic> &lt; 0.001) and skin self\u2010examination (87% <jats:italic>vs<\/jats:italic> 83%, <jats:italic>P<\/jats:italic> = 0.03). Higher socioeconomic status and urban residence were associated with patients at higher risk receiving initial treatment from a specialist doctor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Clinical management of higher risk patients was more likely to conform to clinical practice guidelines for diagnosis and skin surveillance than to melanoma patients at lower risk.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajd.12530","type":"journal-article","created":{"date-parts":[[2016,8,2]],"date-time":"2016-08-02T16:54:12Z","timestamp":1470156852000},"page":"278-285","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Diagnosis and clinical management of melanoma patients at higher risk of a new primary melanoma: A population\u2010based study in New South Wales, Australia"],"prefix":"10.1111","volume":"58","author":[{"given":"Caroline G","family":"Watts","sequence":"first","affiliation":[{"name":"Cancer Epidemiology and Prevention Research Sydney School of Public Health University of Sydney Camperdown New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine M","family":"Madronio","sequence":"additional","affiliation":[{"name":"Cancer Epidemiology and Prevention Research Sydney School of Public Health University of Sydney Camperdown New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachael L","family":"Morton","sequence":"additional","affiliation":[{"name":"NHMRC Clinical Trials Centre University of Sydney Camperdown New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris","family":"Goumas","sequence":"additional","affiliation":[{"name":"Melanoma Institute Australia University of Sydney Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce K","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Cancer Epidemiology and Prevention Research Sydney School of Public Health University of Sydney Camperdown New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Austin","family":"Curtin","sequence":"additional","affiliation":[{"name":"School of Public Health Rural Health Northern Rivers Lismore New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott W","family":"Menzies","sequence":"additional","affiliation":[{"name":"Sydney Melanoma Diagnostic Centre Royal Prince Alfred Hospital Sydney New South Wales Australia"},{"name":"Discipline of Dermatology University of Sydney Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Graham J","family":"Mann","sequence":"additional","affiliation":[{"name":"Melanoma Institute Australia University of Sydney Sydney New South Wales Australia"},{"name":"Centre for Cancer Research Westmead Institute for Medical Research University of Sydney Westmead New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John F","family":"Thompson","sequence":"additional","affiliation":[{"name":"Melanoma Institute Australia University of Sydney Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne E","family":"Cust","sequence":"additional","affiliation":[{"name":"Cancer Epidemiology and Prevention Research Sydney School of Public Health University of Sydney Camperdown New South Wales Australia"},{"name":"Melanoma Institute Australia University of Sydney Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,8]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"Cancer in Australia 2012: An Overview","author":"Australian Institute of Health and Welfare","year":"2012"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archdermatol.2010.2"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2004.10.016"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/jid.2012.75"},{"key":"e_1_2_6_6_1","volume-title":"Clinical Practice Guidelines for The Management of Melanoma In Australia and New Zealand","author":"Australian Cancer Network Melanoma Guidelines Revision Working Party","year":"2008"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.13403"},{"key":"e_1_2_6_8_1","volume-title":"International Classification of Diseases for Oncology","author":"Fritz A","year":"2000"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2014.07.013"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwg074"},{"key":"e_1_2_6_11_1","volume-title":"Rural, Regional and Remote Health: A Guide to Remoteness Classifications","author":"Australian Institute of Health and Welfare","year":"2004"},{"key":"e_1_2_6_12_1","unstructured":"PinkB. 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