Increasing Participation Rates in Germany’s Skin Cancer Screening Program (HELIOS): Protocol for a Mixed Methods Study

Background In 2008, a nationwide skin cancer screening (SCS) program was implemented in Germany. However, participation rates remain low. Objective The overall objective of the HELIOS study is to identify subgroup-specific invitation and communication strategies to increase informed SCS participation in Germany. Methods Focus group discussions will be performed in Erlangen, Germany, to explore potential invitation and communication strategies as well as possible barriers and motivating factors to participate in SCS. Male and female patients of different age groups who have already been diagnosed with skin cancer, as well as participants without a prior diagnosis of skin cancer, will be invited. Based on these results, an online questionnaire will be developed to identify subgroup-specific invitation strategies. A random sample of 2500 persons from the general population aged >35 years from the Munich area will be contacted to complete the questionnaire. Besides descriptive analysis, multinomial logistic regression will be performed. Additionally, a cluster analysis will be conducted to discover patterns or similarities among the participants. Results Recruitment for the focus group studies started in February 2021 and is ongoing. As of August 2021, we have enrolled 39 participants. We expect to end enrollment in the qualitative study in September 2021 and to finish the analysis in December 2021. The second part of the study will then start in January 2022. Conclusions The results of this project will enable us to derive improved and more efficient invitation and communication strategies for SCS. These may be implemented in the future to facilitate increased SCS uptake and early skin cancer detection. International Registered Report Identifier (IRRID) DERR1-10.2196/31860

Assessment of Skin Deep Layer Biochemical Profile Using Spatially Offset Raman Spectroscopy

Skin cancer is currently the most common type of cancer with millions of cases diagnosed worldwide yearly. The current gold standard for clinical diagnosis of skin cancer is an invasive and relatively time-consuming procedure, consisting of visual examination followed by biopsy collection and histopathological analysis. Raman spectroscopy has been shown to efficiently aid the non-invasive diagnosis of skin cancer when probing the surface of the skin. In this study, we employ a recent development of Raman spectroscopy (Spatially Offset Raman Spectroscopy, SORS) which is able to look deeper in tissue and create a deep layer biochemical profile of the skin in areas where cancer lesions subtly evolve. After optimizing the measurement parameters on skin tissue phantoms, we then adopted SORS on human skin tissue from different anatomical areas to investigate the contribution of the different skin layers to the recorded Raman signal. Our results show that using a diffuse beam with zero offset to probe a sampling volume where the lesion is typically included (surface to epidermis-dermis junction), provides the optimum signal-to-noise ratio (SNR) and may be employed in future skin cancer screening applications.

Content Analysis of Skin Cancer Screenings on Pinterest (Preprint)

BACKGROUND Skin cancer rates are rising in the United State yet screening rates remain low. Meanwhile, social media has evolved to become a primary sources of health information with 40% of daily users of Pinterest reporting the platform as a “go-to” source. OBJECTIVE To examine how skin cancer screenings were portrayed on Pinterest. METHODS Using the search terms “skin cancer screening” and “skin cancer exam, researchers sampled every fifth pin to collect 274 relevant pins. Two researchers coded pins and interrater agreement was established at 94%. RESULTS Of the sample, twenty-two percent depicted skin cancer screening in a negative way yet 41.5% noted that early detection leads to better outcomes. The pins were geared toward younger, white, women with minimal depiction of people of color. Few pins included comprehensive information about skin cancer risk factors, importance of routine self-screenings, or what to expect with a medical provider. Fifty-eight percent of pins included links to personal blogs. CONCLUSIONS Social media has become a powerful source of health information yet much of the posted information is incomplete. These findings present public health experts with an opportunity to disseminate more comprehensive skin cancer screening information on social media. CLINICALTRIAL NA

Consumer Preference and Willingness to Pay for Direct-to-Consumer Mobile Teledermoscopy Services in Australia

<b><i>Objective:</i></b> To investigate consumer preference and willingness to pay for mobile teledermoscopy services in Australia. <b><i>Methods:</i></b> Consumers who were taking part in a randomised controlled trial comparing mobile teledermoscopy and skin self-examination were asked to complete a survey which incorporated a discrete choice experiment (DCE) and a contingent valuation question. Responses were used to determine their willingness to pay for mobile teledermoscopy services in Australia and their overall service preferences. <b><i>Results:</i></b> The 199 consumers who responded were 71% female and had a mean age of 42 years (range, 18–73). The DCE results showed that consumers prefer a trained medical professional to be involved in their skin cancer screening. Consumers were willing to pay AUD 41 to change from a general practitioner reviewing their lesions in-person to having a dermatologist reviewing the teledermoscopy images. Additionally, they were willing to pay for services that had shorter waiting times, that reduced the time away from their usual activities, and that have higher accuracy and lower likelihood of unnecessary excision of a skin lesion. When asked directly about their willingness to pay for a teledermoscopy service using a contingent valuation question, the majority (73%) of consumers selected the lowest two value brackets of AUD 1–20 or AUD 21–40. <b><i>Conclusion:</i></b> Consumers are willing to pay out of pocket to access services with attributes such as a dermatologist review, improved accuracy, and fewer excisions.