{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T19:22:54Z","timestamp":1762543374690,"version":"build-2065373602"},"reference-count":37,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,2,17]],"date-time":"2021-02-17T00:00:00Z","timestamp":1613520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Association Against Melanoma","award":["0000"],"award-info":[{"award-number":["0000"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Guidelines recommend limiting melanoma screening in a population with known risk factors, but none indicates methods for efficient recruitment. The purpose of this study is to compare three different methods of recruiting subjects to be screened for melanoma to detect which, if any, is the most efficient. Methods: From 2010 to 2019, subjects were recruited as follows: (1) regular skin examinations (RS), mainly conducted through the Associazione Contro il Melanoma network; (2) occasional melanoma screening (OS), during annual public campaigns; (3) and selective screening (SS), where people were invited to undergo a skin check after filling in a risk evaluation questionnaire, in cases where the assigned outcome was intermediate\/high risk. Melanoma risk factors were compared across different screening methods. Generalized Linear Mixed Models were used for multivariable analysis. Results: A total of 2238 subjects (62.7% women) were recruited, median age 44 years (2\u201385), and 1094 (48.9 %) records were collected through RS, 826 (36.9 %) through OS, and 318 (14.2 %) through SS. A total of 131 suspicious non-melanoma skin cancers were clinically diagnosed, 20 pathologically confirmed, and 2 melanomas detected. SS performed significantly better at selecting subjects with a family history of melanoma and I-II phototypes compared to OS. Conclusions: Prior evaluation of melanoma known risk factors allowed for effective selection of a population to screen at higher risk of developing a melanoma.<\/jats:p>","DOI":"10.3390\/ijerph18041953","type":"journal-article","created":{"date-parts":[[2021,2,17]],"date-time":"2021-02-17T21:35:42Z","timestamp":1613597742000},"page":"1953","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Melanoma Prevention: Comparison of Different Screening Methods for the Selection of a High Risk Population"],"prefix":"10.3390","volume":"18","author":[{"given":"Nevio","family":"Dubbini","sequence":"first","affiliation":[{"name":"Miningful Studio s.r.l.s, 56127 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonella","family":"Puddu","sequence":"additional","affiliation":[{"name":"Plastic Surgery Department, San Rossore Clinic, 56122 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grazia","family":"Salimbeni","sequence":"additional","affiliation":[{"name":"Plastic Surgery Department, San Rossore Clinic, 56122 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Malloggi","sequence":"additional","affiliation":[{"name":"Plastic Surgery Department, San Rossore Clinic, 56122 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniele","family":"Gandini","sequence":"additional","affiliation":[{"name":"Plastic and Reconstructive Surgery Specialist, 56122 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pietro","family":"Massei","sequence":"additional","affiliation":[{"name":"Private Plastic Surgeon, Check-Up Medical Center, 55100 Lucca, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Ferra\u00f9to","sequence":"additional","affiliation":[{"name":"Private Dermatologist, San Rossore Clinic, 56122 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tommaso","family":"Rubino","sequence":"additional","affiliation":[{"name":"Private Dermatologist, 56127 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Ricci","sequence":"additional","affiliation":[{"name":"Dermatology Department, Azienda USL Toscana Nord Ovest, 57025 Piombino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4237-4516","authenticated-orcid":false,"given":"Giovanni","family":"Menchini","sequence":"additional","affiliation":[{"name":"Private Dermatologist, 56127 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Celli","sequence":"additional","affiliation":[{"name":"Dermatology Department, Ospedale Unico Della Versilia, Lido di Camaiore, 55041 Lucca, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurizia","family":"Ghilardi","sequence":"additional","affiliation":[{"name":"Private Dermatologist, 56127 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Gianfaldoni","sequence":"additional","affiliation":[{"name":"Dermatology Department, University \u201cG. Marconi of Rome\u201d, 00193 Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serena","family":"Gianfaldoni","sequence":"additional","affiliation":[{"name":"Dermatology Department, University \u201cG. Marconi of Rome\u201d, 00193 Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Nannipieri","sequence":"additional","affiliation":[{"name":"Dermatology Department, Azienda Ospedaliero-Universitaria Pisana, 56126 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonella","family":"Romanini","sequence":"additional","affiliation":[{"name":"Medical Oncology Department, Azienda Ospedaliero-Universitaria Pisana, 56126 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,2,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1772","DOI":"10.1038\/sj.bjc.6603801","article-title":"Melanoma incidence and mortality in Scotland 1979\u20132003","volume":"96","author":"Mackie","year":"2007","journal-title":"Br. J. Cancer"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"djz106","DOI":"10.1093\/jnci\/djz106","article-title":"Annual Report to the Nation on the Status of Cancer, Featuring Cancer in Men and Women Age 20\u201349 Years","volume":"111","author":"Ward","year":"2019","journal-title":"JNCI J Natl. Cancer Inst."},{"key":"ref_3","unstructured":"American Cancer Society (1993). Facts on Skin Cancer 1993, American Cancer Society. Document #2049."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/jnci\/djv381","article-title":"Stemming the Rising Incidence of Melanoma: Calling Prevention to Action","volume":"108","author":"Gershenwald","year":"2016","journal-title":"J. Nat. Cancer Inst."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1016\/j.pbiomolbio.2011.09.011","article-title":"Reviews on sun exposure and artificial light and melanoma","volume":"107","author":"Gandini","year":"2011","journal-title":"Prog. Biophys. Mol. Biol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1780","DOI":"10.1002\/cncr.23359","article-title":"Age and gender are significant independent predictors of survival in primary cuta-neous melanoma","volume":"112","author":"Lasithiotakis","year":"2008","journal-title":"Cancer"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"S12","DOI":"10.1186\/1476-069X-11-S1-S12","article-title":"Associations between environmental factors and inci-dence of cutaneous melanoma","volume":"11","author":"Volkovova","year":"2012","journal-title":"Rev. Environ. Health"},{"key":"ref_8","first-page":"433","article-title":"Multiple primary melanoma: Two-year results from a population-based study","volume":"142","author":"Perry","year":"2006","journal-title":"Arch. Dermatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1038\/sj.bjc.6602745","article-title":"Site-specific occurrence of nonmelanoma skin cancers in patients with cutaneous melanoma","volume":"93","author":"Neale","year":"2005","journal-title":"Br. J. Cancer"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1046\/j.1365-2133.2002.04750.x","article-title":"A retrospective study of 150 patients with lentigo maligna and lentigo ma-ligna melanoma and the efficacy of radiotherapy using Grenz or soft X-rays","volume":"146","author":"Farshad","year":"2002","journal-title":"Br. J. Dermatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e4757","DOI":"10.1136\/bmj.e4757","article-title":"Cutaneous melanoma attributable to sunbed use: Systematic review and me-ta-analysis","volume":"345","author":"Boniol","year":"2012","journal-title":"BMJ"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2425","DOI":"10.1002\/ijc.25576","article-title":"Sunbed use during adolescence and early adulthood is associated with increased risk of early-onset melanoma","volume":"128","author":"Cust","year":"2010","journal-title":"Int. J. Cancer"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1007\/s11912-012-0256-6","article-title":"Screening and Prevention Measures for Melanoma: Is There a Survival Advantage?","volume":"14","author":"Chen","year":"2012","journal-title":"Curr. Oncol. Rep."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1016\/j.jaad.2007.10.648","article-title":"Screening program reduced melanoma mortality at the Lawrence Livermore National Laboratory, 1984 to 1996","volume":"58","author":"Schneider","year":"2008","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1190","DOI":"10.1038\/jid.2014.452","article-title":"More People Die from Thin Melanomas (\u22641 mm) than from Thick Melanomas (>4 mm) in Queensland, Australia","volume":"135","author":"Whiteman","year":"2015","journal-title":"J. Investig. Dermatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.1002\/cncr.24162","article-title":"Factors related to the presentation of thin and thick nodular melanoma from a popula-tion-based cancer registry in Queensland Australia","volume":"115","author":"Geller","year":"2009","journal-title":"Cancer"},{"key":"ref_17","first-page":"S117","article-title":"Perspective: Catch melanoma early","volume":"515","author":"Swetter","year":"2014","journal-title":"Nat. Cell Biol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.amepre.2014.08.036","article-title":"Prevalence and costs of skin cancer treatment in the U.S.; 2002\u20132006 and 2007\u20132011","volume":"48","author":"Guy","year":"2015","journal-title":"Am. J. Prev. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1097\/00008390-200010020-00011","article-title":"Early detection of melanoma: An educational campaign in Padova, Italy","volume":"10","author":"Rossi","year":"2000","journal-title":"Melanoma Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1046\/j.1365-2133.1996.d01-930.x","article-title":"Total skin examination during screening for malignant mel-anoma does not increase the detection rate","volume":"135","author":"Rampen","year":"1996","journal-title":"Br. J. Dermatol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1111\/j.1468-3083.2006.01865.x","article-title":"Melanoma\/skin cancer screening in a Mediterranean country: Results of the Eu-romelanoma Screening Day Campaign in Greece","volume":"21","author":"Stratigos","year":"2007","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_22","first-page":"18","article-title":"A Global Review of Melanoma Follow-up Guidelines","volume":"6","author":"Campbell","year":"2013","journal-title":"J. Clin. Aesthetic Dermatol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1097\/01.EBP.0000540645.60954.2b","article-title":"Is screening for melanoma effective in primary care?","volume":"17","author":"MacArthur","year":"2014","journal-title":"Evid.-Based Pr."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Sui, A., Wiedmann, M., and Guthmann, R. (2020). Does screening for melanoma improve mortality rates?. Evid. Based Pr.","DOI":"10.1097\/EBP.0000000000000977"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e007471","DOI":"10.1136\/bmjopen-2014-007471","article-title":"Proposal for an annual skin examination by a general practitioner for patients at high risk for melanoma: A French cohort study","volume":"5","author":"Rat","year":"2015","journal-title":"BMJ Open"},{"key":"ref_26","first-page":"CD012352","article-title":"Screening for reducing morbidity and mortality in malignant melanoma","volume":"2019","author":"Johansson","year":"2019","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_27","first-page":"1","article-title":"Cancer prevention and screening: The next step in the era of precision medicine","volume":"3","author":"Umar","year":"2019","journal-title":"NPJ Precis. Oncol."},{"key":"ref_28","first-page":"CD001877","article-title":"Screening for breast cancer with mammography","volume":"6","year":"2013","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_29","first-page":"CD009259","article-title":"Flexible sigmoidoscopy versus faecal occult blood testing for colorectal cancer screening in asymptomatic individuals","volume":"9","author":"Bretthauer","year":"2013","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_30","unstructured":"Alfred Health Victoria (2020, October 07). Melanoma Risk Calculator for the General Public. Available online: https:\/\/www.alfredhealth.org.au\/melanoma-risk-calculator\/public."},{"key":"ref_31","unstructured":"Alfred Health Victoria (2020, October 07). Melanoma Risk Factors. Available online: https:\/\/www.alfredhealth.org.au\/services\/statewide-services\/victorian-melanoma-service\/melanoma-risk-factors."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"9102","DOI":"10.3390\/ijerph120809102","article-title":"Melanoma in the Italian Population and Regional Environmental Influences: A National Retrospective Survey on 2001\u20132008 Hospitalization Records","volume":"12","author":"Piscitelli","year":"2015","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_33","unstructured":"(2020, October 10). Victorian Melanoma Service at the Alfred Hospital (Melbourne, Australia). Available online: https:\/\/www.alfredhealth.org.au\/services\/melanoma-service."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1093\/jnci\/djq099","article-title":"Overdiagnosis in Cancer","volume":"102","author":"Welch","year":"2010","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1884","DOI":"10.1093\/annonc\/mdz411","article-title":"Cutaneous melanoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up","volume":"30","author":"Michielin","year":"2019","journal-title":"Ann. Oncol."},{"key":"ref_36","unstructured":"(2020, October 10). Associazione Contro il Melanoma OdV (ACM) (Pisa, Italy). Available online: https:\/\/www.associazionecontromelanoma.it\/."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12943-018-0757-5","article-title":"Liquid biomarkers in melanoma: Detection and discovery","volume":"17","author":"Lim","year":"2018","journal-title":"Mol. Cancer"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/4\/1953\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:25:22Z","timestamp":1760160322000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/4\/1953"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,17]]},"references-count":37,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,2]]}},"alternative-id":["ijerph18041953"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18041953","relation":{},"ISSN":["1660-4601"],"issn-type":[{"type":"electronic","value":"1660-4601"}],"subject":[],"published":{"date-parts":[[2021,2,17]]}}}