SELF-EXAMINATION could help improve early detection of melanoma, but new research suggests many patients lack confidence in monitoring their own skin. Baseline data from the MEL-SELF trial reveal important gaps in knowledge, behaviour, and psychological readiness.
Melanoma Self-Examination and Patient Engagement
Follow up care after melanoma treatment traditionally relies on clinician led monitoring. However, melanoma self-surveillance has emerged as a potential complementary strategy that empowers patients to perform regular skin self-examination and identify suspicious lesions earlier.
The MEL-SELF trial was designed to evaluate whether patient led melanoma self-examination could serve as an alternative follow up model. Researchers aimed to better understand patient characteristics, knowledge, and behaviours before testing whether structured self-surveillance programmes could support earlier melanoma detection and improved psychological outcomes.
Baseline Findings from the Melanoma Self Surveillance Trial
Researchers analysed recruitment and baseline data from December 2021 to June 2024 across dermatologist and general practitioner led skin cancer clinics in Australia. The study included adults previously treated for early-stage melanoma, specifically AJCC stages 0-II, who attended routine follow up appointments.
Of 1226 patients screened, 504 participants were randomised to the MEL-SELF trial. Among them, 251 were assigned to patient led surveillance and 253 to clinician led surveillance. The study population included 295 female individuals (59%) and 209 male individuals (41%), with a mean (SD) age of 56.0 (11.6) years.
Clinical characteristics showed that many participants had early disease stages, including melanoma in situ in 245 participants (49%) and stage IA in 217 participants (43%). However, melanoma self-surveillance practices varied considerably. 103 participants (20%) had not performed skin self-examination in the previous 12 months, while 160 participants (32%) reported weekly or monthly examinations.
Psychological measures revealed additional challenges. 232 participants (46%) reported clinically significant fear of cancer recurrence, which was associated with younger age, female sex, and higher depression, anxiety, and stress scores.
Implications for Future Melanoma Self Surveillance Strategies
These findings suggest that melanoma self-surveillance programmes may need to address both behavioural and psychological barriers to ensure effectiveness. Many patients demonstrated limited confidence in performing skin self-examination despite having access to digital tools.
Future results from the MEL-SELF trial will examine whether structured melanoma self-surveillance interventions, including mobile dermatoscopes and teledermatology assessments, improve detection and patient wellbeing.
If effective, melanoma self-surveillance could become a valuable addition to routine melanoma follow up, supporting earlier identification of suspicious lesions while empowering patients to participate more actively in their own care.
Reference
Medcalf E et al. Characteristics of participants screened and randomized to the melanoma self surveillance trial. JAMA Dermatol. 2026;DOI:10.1001/jamadermatol.2026.0083.
Featured image: 淼 王 on Adobe Stock
