Evaluation of targeted screening in high risk melanoma patients using: 3D full body imaging, genomic risk assessment and functional testing of gene variants.

The intervention is a targeted screening program for people who are at high risk to melanoma. This screening program involves visits to the Clinical Research Facility at Princess Alexandra Hospital every 6 months for a period of 2 years (5 visits in total). At these visits participants will complete questionnaires (clinical examination form and 'melanoma surveillance - a patients perspective' questionnaire), they will donate a saliva sample for genetic sequencing (baseline visit only), and they will have 3D full body imaging done with further dermoscopic imaging of all naevi larger than 3mm. Participants will be seen by either a Dermatologist or a clinical research assistant trained by a dermatologist. A second Research Assistant will also be present at participant visits. Patient visits should take between 1-2 hours, depending on the amount of moles the participant has. All images taken at patient visits will be reviewed by a dermatologist. The saliva sample will be used for genetic analysis that will be used to identify genes associated with high risk of melanoma. This information will be used for further research into melanoma risk, but will not affect the intervention, i.e. participant visits will be the same regardless of genetic findings. We will also collect healthcare data for cost/benefit analysis A substudy will evaluate the feasibility of using telehealth services to review 3D full body imaging remotely for a clinical skin examination. Both the technical feasibility of the telehealth network, including interoperability with hospital image repositories and integrated electronic medical records will be evaluated, with addition to the accuracy and concordance of skin examinations between a in-person clinical skin check compared with a teledermatological diagnosis.