Poster Presentation Australasian Melanoma Conference 2026

Q-Inform: A randomised control trial of risk-stratified screening advice for melanoma – study design and recruitment (#423)

Lillian Macfarlane 1 2 , Huanwei Wang 1 3 , Hadis Ghajari 1 4 , Shanika Jayasinghe 1 3 5 , Mathias Seviiri 3 , Lea Jackman 2 , Nirmala Pandeya 2 6 , Catherine Olsen 2 5 7 , Anne Cust 8 9 , Aideen McInerney-Leo 5 , Stuart MacGregor 3 , David Whiteman 2 4 , Rachel Neal 6 10 , Matthew Law 1 2 3
  1. Genetics and Skin Cancer Group, Population Health Program, QIMR Berghofer, Brisbane, QLD, Australia
  2. Cancer Control Group, QIMR Berghofer, Brisbane, QLD, Australia
  3. Statistical Genetics Group, QIMR Berghofer, Brisbane, QLD, Australia
  4. School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
  5. Frazer Institute, The University of Queensland, Brisbane, QLD, Australia
  6. School of Public Health, The University of Queensland, Brisbane, QLD, Australia
  7. QIMR Berghofer, Herston, QLD, Australia
  8. Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
  9. The Daffodil Centre, The University of Sydney, and Cancer Council NSW, Sydney, NSW, Australia
  10. Cancer Aetiology & Prevention Group, QIMR Berghofer, Brisbane, QLD, Australia

Background/aim: Although early detection of melanoma has potential benefits, population‑wide skin screening is not recommended due to insufficient evidence of the balance of benefits and harms. Current RACGP guidelines recommend opportunistic skin examination only for individuals at above‑average risk for melanoma. It remains unclear whether providing personalised melanoma risk information motivates individuals to engage in recommended skin‑screening behaviours. This study aims to compare the impact of delivering a clinical risk score or a genetic risk score versus a control group on adherence to recommended skin examination advice, sun-safety behaviours, and melanoma‑related worry.

Methods: This open‑label randomised controlled trial, nested within the QSkin cohort, will compare three conditions: receiving a clinical risk score (CRS) for melanoma, versus receiving a genetic risk score (GRS) for melanoma, versus receiving general advice on sun-safety (control arm).

Eligible participants:
  • 51-75 years old (inclusive)
  • No history of invasive or in situ melanoma
  • Have a concordant clinical risk score versus genetic risk score.

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Participants randomised to intervention arms will receive a booklet containing their personalised risk score (clinical or genetic), tailored advice to their risk group, and general sun-safety information. Participants in the control group will receive general sun-safety information only. Adherence to recommended skin examinations, sun‑safety behaviours, and melanoma‑related worry will be assessed using monthly self‑report surveys over a 12‑month follow‑up period. Semi‑structured qualitative interviews will be conducted with a subset of participants to explore perceptions of melanoma risk information and motivations for screening behaviour.

Recruitment: 9,870 QSkin participants are eligible for invitation, with an anticipated ~50% response rate. CRS will be recalculated at baseline using updated participant data as some factors influencing CRS may have changed. As prior QSkin data showing 30% non-adherence, 247 participants per arm are required to detect a 40% relative reduction in non-adherence with 80% power, allowing for a 20% dropout rate. Expected recruitment will provide adequate power to detect smaller effect sizes.

Conclusions: This study will provide evidence on whether personalised CRSs or GRSs can influence adherence with risk‑appropriate skin checks. Findings will inform the feasibility and risks of implementing risk‑stratified melanoma screening programs in Australia.