Poster Presentation Australasian Melanoma Conference 2026

What is the evidence for follow-up and surveillance after melanoma in situ? A systematic review of guidelines and evidence  (#404)

Molly Carter 1 , Shannon Pike 1 2 , Linda Martin 3 4 , Richard Harrison 1 5 , Heba Azer 1
  1. University of New South Wales, Wagga Wagga, NSW, Australia
  2. Wagga Wagga Ambulatory Rehabilitation Service, Murrumbidgee Local Health District, Wagga Wagga, NSW, Australia
  3. University of New South Wales, Sydney, NSW, Australia
  4. Melanoma Institute of Australia , Sydney, NSW, Australia
  5. Melanoma Institute Australia, Wagga Wagga, NSW, Australia

Background 

Melanoma in situ (MIS) is the most commonly diagnosed stage of melanoma in Australia. Patients with a history of MIS are at risk of local recurrence and have increased risk of subsequent primary melanoma. Current Australian clinical practice guidelines (CPGs) lack specific recommendations for short- and long-term follow-up and surveillance of patients with MIS, contributing to variation in clinical practice. This systematic review aims to identify current CPGs and contemporary studies addressing MIS follow-up and surveillance, critically appraise their methodological rigor and synthesise existing recommendations. 

 

Methods 

A systematic search of Embase, PubMed and the Guidelines International Network was conducted between January 2014 - April 2025 to identify CPGs with recommendations for MIS follow-up and surveillance. Guideline quality was assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool by two independent reviewers. A second systematic search of Embase and PubMed was conducted between January 2010 -April 2025 to identify original studies providing recommendations on the frequency and duration of follow-up and surveillance after MIS. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal tools. Findings were synthesised using a narrative approach.  

 

Results 

Thirteen international CPGs were identified. Only four provided specific recommendations for MIS follow-up, excluding Australia, which offered no recommendation. Follow-up ranged from a single post-treatment visit to biannual or annual follow-up. Recommendations for surveillance extended from the first year only to lifelong monitoring. These recommendations were based on low-level evidence or expert consensus. Five cohort studies and one cross-sectional study, with low to moderate risk of bias provided recommendations including no follow-up, follow-up of less than 3 months, long-term follow-up (unspecified), follow-up exceeding ten years, and lifelong surveillance with frequency tailored according to original tumour characteristics and individual risk factors for subsequent melanoma.  

 

Conclusions  

This systematic review highlights the lack of evidence or consensus regarding frequency and duration of follow-up and surveillance recommendations after MIS. Research is needed to inform evidence-based guidelines and support consistent clinical practice following a MIS diagnosis, to optimise patient outcomes and health resource utilisation.