Impact of personal genomic risk information on melanoma prevention behaviors and psychological outcomes: a randomized controlled trial

Amelia K Smit; Martin Allen; Brooke Beswick; Phyllis Butow; Hugh Dawkins; Suzanne J Dobbinson; Kate L Dunlop; David Espinoza; Georgina Fenton; Peter A Kanetsky; Louise Keogh; Michael G Kimlin; Judy Kirk; Matthew H Law; Serigne Lo; Cynthia Low; Graham J Mann; Gillian Reyes-Marcelino; Rachael L Morton; Ainsley J Newson; Jacqueline Savard; Lyndal Trevena; Sarah Wordsworth; Anne E Cust

doi:10.1038/s41436-021-01292-w

Impact of personal genomic risk information on melanoma prevention behaviors and psychological outcomes: a randomized controlled trial

Genet Med. 2021 Dec;23(12):2394-2403. doi: 10.1038/s41436-021-01292-w. Epub 2021 Aug 12.

Authors

Amelia K Smit^{1

2}, Martin Allen³, Brooke Beswick¹, Phyllis Butow⁴, Hugh Dawkins^{5

6}, Suzanne J Dobbinson⁷, Kate L Dunlop¹, David Espinoza⁸, Georgina Fenton¹, Peter A Kanetsky⁹, Louise Keogh¹⁰, Michael G Kimlin¹¹, Judy Kirk¹², Matthew H Law^{13

14}, Serigne Lo², Cynthia Low¹⁵, Graham J Mann^{2

16}, Gillian Reyes-Marcelino¹, Rachael L Morton^{2

8}, Ainsley J Newson¹⁷, Jacqueline Savard¹⁸, Lyndal Trevena¹⁹, Sarah Wordsworth²⁰, Anne E Cust^{21

22}

Affiliations

¹ The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, NSW, Sydney, Australia.
² Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
³ Electrical and Computer Engineering, University of Canterbury, Christchurch, New Zealand.
⁴ Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, The University of Sydney, Sydney, NSW, Australia.
⁵ Division of Genetics, School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia.
⁶ School of Medicine, The University of Notre Dame, Notre Dame, NSW, Australia.
⁷ Cancer Council Victoria, Melbourne, VIC, Australia.
⁸ NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia.
⁹ H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
¹⁰ Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia.
¹¹ Queensland University of Technology, School of Biomedical Sciences, Brisbane, QLD, Australia.
¹² Westmead Clinical School and Westmead Institute for Medical Research, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
¹³ Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
¹⁴ Queensland University of Technology (QUT), Brisbane, QLD, Australia.
¹⁵ Consumer representative, Brisbane, QLD, Australia.
¹⁶ The John Curtin School of Medical Research, ANU College of Health and Medicine, ANU, ACT, Canberra, Australia.
¹⁷ Sydney Health Ethics, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.
¹⁸ School of Medicine, Faculty of Health, Deakin University, Geelong, VIC, Australia.
¹⁹ Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.
²⁰ Health Economics Research Centre, The University of Oxford, Oxford, UK.
²¹ The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, NSW, Sydney, Australia. anne.cust@sydney.edu.au.
²² Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia. anne.cust@sydney.edu.au.

Abstract

Purpose: We evaluated the impact of personal melanoma genomic risk information on sun-related behaviors and psychological outcomes.

Methods: In this parallel group, open, randomized controlled trial, 1,025 Australians of European ancestry without melanoma and aged 18-69 years were recruited via the Medicare database (3% consent). Participants were randomized to the intervention (n = 513; saliva sample for genetic testing, personalized melanoma risk booklet based on a 40-variant polygenic risk score, telephone-based genetic counseling, educational booklet) or control (n = 512; educational booklet). Wrist-worn ultraviolet (UV) radiation dosimeters (10-day wear) and questionnaires were administered at baseline, 1 month postintervention, and 12 months postbaseline.

Results: At 12 months, 948 (92%) participants completed dosimetry and 973 (95%) the questionnaire. For the primary outcome, there was no effect of the genomic risk intervention on objectively measured UV exposure at 12 months, irrespective of traditional risk factors. For secondary outcomes at 12 months, the intervention reduced sunburns (risk ratio: 0.72, 95% confidence interval: 0.54-0.96), and increased skin examinations among women. Melanoma-related worry was reduced. There was no overall impact on general psychological distress.

Conclusion: Personalized genomic risk information did not influence sun exposure patterns but did improve some skin cancer prevention and early detection behaviors, suggesting it may be useful for precision prevention. There was no evidence of psychological harm.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Aged
Australia
Female
Genomics
Humans
Melanoma* / diagnosis
Melanoma* / genetics
Melanoma* / prevention & control
Middle Aged
National Health Programs
Skin Neoplasms* / genetics
Skin Neoplasms* / prevention & control
Young Adult