A Randomized Trial of Precision Prevention Materials to Improve Primary and Secondary Melanoma Prevention Activities among Individuals with Limited Melanoma Risk Phenotypes

Abstract

Inherited variation at MC1R is associated with elevated melanoma risk among non-Hispanic whites (NHWs). MC1R genetic testing may unmask previously unrecognized disease risk, especially among individuals with few melanoma phenotypic risk factors. We recruited NHW individuals with limited phenotypic risk factors from two primary care clinics in west-central Florida. Participants (n = 1134) were randomized within MC1R genotype risk group (average/higher) to receive mailed precision prevention (i.e., intervention) or generic prevention materials. Participants reported hours of weekday and weekend sun exposure, frequency of intentional outdoor tanning and sun protection behaviors, number of sunburns, indoor tanning episodes, and skin examinations at baseline, and after 6 and 12 months. Among MC1R higher-risk participants, the intervention increased the likelihood of often or always wearing a shirt with sleeves (OR = 1.49, p = 0.03) and seeking shade or using an umbrella (OR = 1.42, p = 0.046), and it decreased the number of sunburns among their young children (β = −0.13, p = 0.03). Intervention effects were not noted among MC1R average-risk participants. Moderation analyses identified intervention effects within subgroups in average-risk and higher-risk participants. Precision prevention information conveying MC1R testing results can increase the practice of some sun protection behaviors among at-risk individuals with limited melanoma risk phenotypes and may provide a cross-generational tool to counteract increasing incidence of melanoma.

Communicating Personal Melanoma Polygenic Risk Information: Participants’ Experiences of Genetic Counseling in a Community-Based Study

“…Non-genetics health professionals could be trained to offer testing and deliver results to assist in managing the volume and scale required for population-level testing. In two randomized controlled trials in primary care settings in the US, intervention arm participants were posted hardcopy booklets presenting their personal melanoma genomic risk information and educational information on prevention and early detection, followed by a phone call by a trained researcher or health educator (as opposed to a genetic counselor) [ 35 , 36 ]. Participant satisfaction with these study processes was high overall.…”

Interest and Utility of MC1R Testing for Melanoma Risk in Dermatology Patients with a History of Nonmelanoma Skin Cancer

“…[22,37] In these studies and others, the provision of MC1R and similar melanoma genetic risk test results lead to behavioral activation but not worry and promote increased use of sun protection and skin screening, as well as reductions in sunburn in individuals who received the feedback. Further, individuals who receive average risk feedback do not increase risk behaviors such as tanning [38][39][40]. Current genetic testing technology allows for lowcost comprehensive genomic assessment, and MC1R is often 1.00 (0.00) Afraid [1][2][3][4][5][6][7] 1.50 (1.10) Hopeful [1][2][3][4][5][6][7] 4.63 (2.36) Confused [1][2][3][4][5][6][7] 1.94 (1.61) Determined to change [1][2][3][4][5][6][7] 4.38 (2.53) Distress, Sum 8.81 (2.23) evaluated as part of direct-to-consumer genetic tests.…”

Associations between social COVID-19 exposure and psychological functioning

“…Both studies predominately recruited participants from two non-specialty, academic clinic settings in Tampa, Florida, U.S.A. Details of these studies have been published elsewhere (Lacson et al, 2021 , 2022 ). Trial participants who previously (i) consented to be re-contacted for future studies, (ii) provided an email address, (iii) completed the baseline study questionnaire for the intervention trial, (iv) indicated English as a language preference, and were (iv) less than 89 years of age and (v) not under active trial follow up were sent an email inviting them to participate in a COVID-19 research study.…”