The feasibility of targeted screening for cutaneous malignant melanoma in t
he UK using a postal questionnaire and invitation to screening by a consult
ant dermatologist was investigated in a population based cross-sectional su
rvey. A total of 1600 people aged 25-69 years, stratified by the social dep
rivation score of wards within one general practice, were randomly selected
from a population of 8000.1227 (77%) returned the questionnaire and 896 (5
6%) attended the screening clinic. Uptake was lower for men (P < 0.001), th
ose aged under 50 (P < 0.001), people from deprived areas (P < 0.001) and s
kin types III and IV (men only, P < 0.001). Twenty per cent of women and 10
% of men felt nervous about attending the clinic, but only 4% were worried
by the questionnaire. The level of agreement between the self- and dermatol
ogist's assessments of risk factors was best for hair colour (Kappa = 0.67,
sensitivity 73% and specificity 98%). People tended to under-report their
level of risk. Over 95% knew about at least one major sign, but 54% reporte
d incorrect signs of melanoma. Targeted screening for melanoma in the UK wi
ll be hampered by difficulties in accurately identifying the target populat
ion. Strategies to improve skin self-awareness rather than screening should
be developed and evaluated. (C) 2000 Cancer Research Campaign.