Melanoma Risk Assessment Tool

Last modified date: 09/10/2008

 

Question 1:
Does the patient live in the Northern, Central, or Southern United States?

Explanation
Melanoma is more common in people who live in areas that get large amounts of UV radiation from the sun. For example, melanoma is more common in California than in Minnesota, where the sun is not as strong.

Question 2:
What is the patient's gender?

Explanation
In the United States, melanoma incidence is higher for men than for women. Risk factors for melanoma and sun behavior patterns are also different between men and women.

Question 3:
What is the patient's race?

Explanation
The risks are estimated only for non-Hispanic whites; data on other ethnicities were too limited to accurately estimate risk. White people get melanoma far more often than do African American people, probably because light skin is more easily damaged by the sun.

Question 4:
What is the patient's age?

Explanation
The risk of developing melanoma increases with age. Most cancers develop slowly over time. For this reason, melanoma is more common among older individuals.

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Question 5:
Has the patient ever had a blistering sunburn?

Explanation
People who have had at least one severe, blistering sunburn are at increased risk of melanoma. Doctors advise protection from the sun to reduce the risk of melanoma.

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Question 5 for females:
Question 6 for males:
Is the patient's complexion light, medium, or dark?

Explanation
Melanoma occurs more frequently in people who have fair skin that burns or freckles easily (these people also usually have red or blond hair and blue eyes) than in people with dark skin, probably because light skin is more easily damaged by the sun.

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Question 6 (for females only):
After repeated and prolonged exposure to sunlight, at the age the patient is now, how tan would the patient's skin become?

Explanation
Melanoma occurs more frequently in people who have skin that burns easily and does not tan well. Sun resistance, or the ability to tan instead of burn when exposed to the sun, has been associated with a lower risk of melanoma. People who tan well, however, are also at risk of melanoma and their risk is higher the more sun exposure that they have.

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Question 7 (for males only):
How many moles larger than 5mm in diameter are on the patient's back?

Explanation
Having many moles increases the risk of developing melanoma. Dysplastic nevi are larger moles that are more likely than ordinary moles to become cancerous. The back and shoulders are commonly and readily examined and the evaluation is easier than on chronically exposed areas.

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Question 7 for females:
Question 8 for males:
How many moles less than or equal to 5mm in diameter are on the patient's back?

Explanation
Having many moles, particularly larger moles, increases the risk of developing melanoma. The back and shoulders are commonly and readily examined and the evaluation is easier than on chronically exposed areas. Characteristics of the back are highly correlated with total body characteristics.

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Question 8 for females:
Question 9 for males:
How extensive is the freckling on the patient's back and shoulders?

Explanation
Melanoma occurs more frequently in people who have fair skin that freckles easily. The back and shoulders are commonly and readily examined and the evaluation is easier than on chronically exposed areas.

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Question 10 (for males only):
Does the patient have severe solar damage on the shoulders?

Explanation
UV radiation from the sun causes premature aging of the skin and skin damage that can lead to melanoma.

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Explaining the Results

The Melanoma Risk Assessment Tool will estimate an individual's risk of developing melanoma during the next 5-year period and up to age 70 based on the risk factor information provided. Risk estimates calculated by the tool are estimates of absolute melanoma risk. Absolute melanoma risk is the chance or probability of developing melanoma in a defined age interval. Although an individual's risk may be accurately estimated, these predictions do not allow one to say precisely who will develop melanoma cancer.

The MRAT risk calculator may be updated periodically as new data or research becomes available.

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About the Model

The Melanoma Risk Assessment Tool is based on a statistical model. The model uses patient's self-reported history and a brief physical exam by a health care professional. Data from a case-control study involved 1663 non-Hispanic white patients from clinics in Philadelphia, PA and San Francisco, CA were used in developing the model. This model has not been tested in large populations. In other words, the model has not been "validated" for all non-Hispanic whites. Researchers are conducting additional studies and welcome partnerships to validate this tool.

The MRAT risk calculator may be updated periodically as new data or research becomes available. The system is currently on statistical model version 1 and software version 2.0

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Reference

Fears TR, Guerry D IV, Pfeiffer RM, et al: Identifying Individuals at High Risk of Melanoma: A Practical Predictor of Absolute Risk. J Clin Oncol 24(22): pp-pp, 2006.

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