{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T03:47:12Z","timestamp":1767844032635,"version":"3.49.0"},"reference-count":36,"publisher":"BMJ","issue":"6984","license":[{"start":{"date-parts":[[1995,4,8]],"date-time":"1995-04-08T00:00:00Z","timestamp":797299200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"accepted":{"date-parts":[[1995,1,27]]},"published-print":{"date-parts":[[1995,4,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Objective<\/jats:bold>\n                    : To validate self screening by patients of high mole counts, assess the within family association of sun protection behaviour and mole counts, and estimate prevalence of risk factors for melanoma.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Setting and subjects<\/jats:bold>\n                    : Systematic sample of families from a single affluent general practice population in Wessex.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Design<\/jats:bold>\n                    : Subjects completed a questionnaire about risk factors for melanoma and counted their moles. Subsequently a mole count was done by a general practitioner trained at dermatology clinics.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Main outcome measures<\/jats:bold>\n                    : Validation of self counts by observer's count. Within family association of sun protection behaviour and mole counts; self reported risk factors.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results<\/jats:bold>\n                    : 199\/237 subjects (84%) returned the questionnaire; 212\/237 (89%) were examined. High counts by patients on the front of the trunk (&gt;7 moles of &gt;\/=2 mm) were reasonably sensitive (79%), predictive (75%), and specific (97%) of the observer's mole counts ((kappa)=0.74), unlike arm or total body counts. Sun protection behaviour correlated between individuals and other family members (Spearman's coefficient r=0.50, P&lt;0.01). In the past three months 15\/114 adults (13.2%, 95% confidence interval 7.0% to 19.4%) reported any change in a mole and 6\/114 (5.3%, 2.0% to 11.1%) \u201cmajor\u201d changes; 6\/109 adults (5.5%, 2.1% to 11.6%) had both high mole counts and freckling.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions<\/jats:bold>\n                    : Asking patients to count trunk moles could be a feasible way of identifyng patients at high risk of melanoma. Concentrating on reported major changes in moles should avoid considerable workload in general practice. The generalisability of these findings and the adverse effects, net benefit in earlier diagnosis and prevention, and workload implications of such self screening need further research.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:boxed-text position=\"float\">\n                      <jats:sec>\n                        <jats:title>Key messages<\/jats:title>\n                        <jats:list list-type=\"bullet\">\n                          <jats:list-item>\n                            <jats:p>Key messages<\/jats:p>\n                          <\/jats:list-item>\n                          <jats:list-item>\n                            <jats:p>Simple self screening of trunk moles may be feasible to identify high risk individuals<\/jats:p>\n                          <\/jats:list-item>\n                          <jats:list-item>\n                            <jats:p>Sun protection behaviour is associated within families<\/jats:p>\n                          <\/jats:list-item>\n                          <jats:list-item>\n                            <jats:p>Advice about changes in moles should emphasise the need to report only major changes (size, shape, colour), otherwise the assessment workload may increase substantially<\/jats:p>\n                          <\/jats:list-item>\n                        <\/jats:list>\n                      <\/jats:sec>\n                    <\/jats:boxed-text>\n                  <\/jats:p>","DOI":"10.1136\/bmj.310.6984.912","type":"journal-article","created":{"date-parts":[[2011,10,27]],"date-time":"2011-10-27T19:33:59Z","timestamp":1319744039000},"page":"912-916","source":"Crossref","is-referenced-by-count":31,"title":["Self screening for risk of melanoma: validity of self mole counting by patients in a single general practice"],"prefix":"10.1136","volume":"310","author":[{"given":"Paul","family":"Little","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Keefe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"White","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1995,4,8]]},"reference":[{"key":"2025122509561409000_310.6984.912.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.1990.tb02132.x"},{"key":"2025122509561409000_310.6984.912.2","doi-asserted-by":"crossref","first-page":"680","DOI":"10.5694\/j.1326-5377.1986.tb113693.x","article-title":"Melanoma survival rates in South Australia by histological type, thickness and level of tumour at diagnosis.","volume":"144","author":"Bonett","year":"1986","journal-title":"Med J Aust"},{"key":"2025122509561409000_310.6984.912.3","first-page":"523","article-title":"The role of primary care in the prevention of melanoma.","volume":"44","author":"Johnson","year":"1994","journal-title":"Br J Gen Pract"},{"key":"2025122509561409000_310.6984.912.4","doi-asserted-by":"crossref","first-page":"1555","DOI":"10.1136\/bmj.292.6535.1555","article-title":"Benign melanocytic naevi as a risk factor for malignant melanoma.","volume":"292","author":"Swerdlow","year":"1986","journal-title":"BMJ"},{"key":"2025122509561409000_310.6984.912.5","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1002\/ijc.2910420210","article-title":"The Danish case-control study of cutaneous malignant melanoma: I: Importance of host factors.","volume":"42","author":"Osterlind","year":"1988","journal-title":"Int J Cancer"},{"key":"2025122509561409000_310.6984.912.6","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1093\/oxfordjournals.aje.a114851","article-title":"Self reports of mole counts and cutaneous malignant melanoma in women: methodological issues and risks of disease.","volume":"127","author":"Bain","year":"1988","journal-title":"Am J Epidemiol"},{"key":"2025122509561409000_310.6984.912.7","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1136\/bmj.296.6632.1285","article-title":"Identifying people at high risk of cutaneous malignant melanoma: results from a case control study in Western Australia.","volume":"296","author":"English","year":"1988","journal-title":"BMJ"},{"key":"2025122509561409000_310.6984.912.8","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/19.4.801"},{"key":"2025122509561409000_310.6984.912.9","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1002\/ijc.2910350303","article-title":"Common acquired nevi and the risk of malignant melanoma.","volume":"35","author":"Green","year":"1985","journal-title":"Int J Cancer"},{"key":"2025122509561409000_310.6984.912.10","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19900715)66:2<387::AID-CNCR2820660232>3.0.CO;2-J"},{"key":"2025122509561409000_310.6984.912.11","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1016\/S0190-9622(87)70230-8","article-title":"Number of melanocytic nevi as a major risk factor for malignant melanoma.","volume":"17","author":"Holly","year":"1987","journal-title":"J Am Acad Dermatol"},{"key":"2025122509561409000_310.6984.912.12","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1111\/j.1365-2133.1994.tb06882.x","article-title":"Reliability of naevus counts in identifying individuals at high risk of malignant melanoma.","volume":"130","author":"Byles","year":"1944","journal-title":"Br J Dermatol"},{"key":"2025122509561409000_310.6984.912.13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1988.tb02564.x"},{"key":"2025122509561409000_310.6984.912.14","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1001\/archderm.1978.01640170032006","article-title":"Origin of familial malignant melanomas from heritable melanocytic lessions: \u201cthe B.K. mole syndrome.\u201d","volume":"114","author":"Clark","year":"1988","journal-title":"Arch Dermatol"},{"key":"2025122509561409000_310.6984.912.15","doi-asserted-by":"publisher","DOI":"10.1111\/1523-1747.ep13076732"},{"key":"2025122509561409000_310.6984.912.16","doi-asserted-by":"crossref","unstructured":"Newton J .Familial melanoma. In: Kirkham N Cotton DWK Lallemand RC White J Rosin RD eds. Diagnosis and management of melanoma in clinical practice. London: Springer-Verlag, 1992: 53\u201360.","DOI":"10.1007\/978-1-4471-1925-8_5"},{"key":"2025122509561409000_310.6984.912.17","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1983.tb07077.x"},{"key":"2025122509561409000_310.6984.912.18","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.2910420303"},{"key":"2025122509561409000_310.6984.912.19","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1136\/bmj.288.6411.99","article-title":"Pigmentation and skin reaction to sun as risk factors for cutaneous malignant melanoma.","volume":"288","author":"Elwood","year":"1994","journal-title":"BMJ"},{"key":"2025122509561409000_310.6984.912.20","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1002\/ijc.2910350403","article-title":"Cutaneous melanoma in relation to intermittent and constant sun exposure\u2014the Western Canada melanoma study.","volume":"35","author":"Elwood","year":"1994","journal-title":"Int J Cancer"},{"key":"2025122509561409000_310.6984.912.21","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1038\/bjc.1982.307","article-title":"Severe sunburn and subsequent risk of primary cutaneous malignant melanoma in Scotland.","volume":"46","author":"MacKie","year":"1982","journal-title":"Br J Cancer"},{"key":"2025122509561409000_310.6984.912.22","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1542\/peds.84.2.199","article-title":"Nonfamilial cutaneous melanoma incidence in women associated with sun exposure before 20 years of age.","volume":"84","author":"Weinstock","year":"1989","journal-title":"Pediatrics"},{"key":"2025122509561409000_310.6984.912.23","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1038\/bjc.1985.77","article-title":"Sunburn, suntan, and the risk of cutaneous malignant melanoma\u2014the Western Canada melanoma study.","volume":"51","author":"Elwood","year":"1985","journal-title":"Br J Cancer"},{"issue":"a","key":"2025122509561409000_310.6984.912.24","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1016\/0959-8049(92)90480-P","article-title":"Cutaneous melanoma and sunburns in childhood in a southern European population.","volume":"28","author":"Zanetti","year":"1992","journal-title":"Eur J Cancer"},{"key":"2025122509561409000_310.6984.912.25","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1038\/bjc.1985.53","article-title":"Sunburn and malignant melanoma.","volume":"51","author":"Green","year":"1985","journal-title":"Br J Cancer"},{"key":"2025122509561409000_310.6984.912.26","first-page":"257","article-title":"Pigmentary traits, ethnic origin, benign naevi, and family history as risk factors for cutaneous malignant melanoma.","volume":"72","author":"D'Arcy","year":"1994","journal-title":"Journal of the National Cancer Institute"},{"key":"2025122509561409000_310.6984.912.27","first-page":"75","volume":"308","author":"Marks","year":"1994","journal-title":"Sunburn and melanoma: how strong is the evidence? BMJ"},{"key":"2025122509561409000_310.6984.912.28","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197307)32:1<191::AID-CNCR2820320129>3.0.CO;2-W"},{"key":"2025122509561409000_310.6984.912.29","doi-asserted-by":"crossref","unstructured":"Cooke KR Spears GFS Skegg DCG .Frequency of moles in a defined population. J Epidemiol Community Health 1985;39: -52.","DOI":"10.1136\/jech.39.1.48"},{"key":"2025122509561409000_310.6984.912.30","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/S0140-6736(86)90837-8","article-title":"Statistical methods for assessing agreement between two methods of clinical measurement.","volume":"i","author":"Bland","year":"1986","journal-title":"Lancet"},{"key":"2025122509561409000_310.6984.912.31","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1001\/archsurg.1952.01260020856010","article-title":"Regional distribution of moles and melanomas.","volume":"65","author":"Pack","year":"1952","journal-title":"Arch Surg"},{"key":"2025122509561409000_310.6984.912.32","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1985.tb02060.x"},{"key":"2025122509561409000_310.6984.912.33","doi-asserted-by":"publisher","DOI":"10.1016\/0091-7435(88)90003-5"},{"key":"2025122509561409000_310.6984.912.34","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1136\/bmj.301.6742.26","article-title":"Reducing the psychological costs.","volume":"301","author":"Marteau","year":"1991","journal-title":"BMJ"},{"key":"2025122509561409000_310.6984.912.35","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19890315)63:6<1240::AID-CNCR2820630635>3.0.CO;2-9"},{"key":"2025122509561409000_310.6984.912.36","first-page":"677","article-title":"Genetics of melanoma.","volume-title":"British Medical Bulletin","volume":"50","author":"Newton","year":"1994"}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.310.6984.912","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.310.6984.912","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,25]],"date-time":"2025-12-25T17:56:27Z","timestamp":1766685387000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.310.6984.912"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1995,4,8]]},"references-count":36,"journal-issue":{"issue":"6984","published-online":{"date-parts":[[1995,4,8]]},"published-print":{"date-parts":[[1995,4,8]]}},"alternative-id":["10.1136\/bmj.310.6984.912"],"URL":"https:\/\/doi.org\/10.1136\/bmj.310.6984.912","relation":{},"ISSN":["0959-8138","1468-5833"],"issn-type":[{"value":"0959-8138","type":"print"},{"value":"1468-5833","type":"electronic"}],"subject":[],"published":{"date-parts":[[1995,4,8]]}}}