Study Components

The WAMHS will enable the study of potential genetic and environmental factors that may contribute to melanoma in adults. The database will be linked to other comprehensive data sets from the WA population, to further enhance investigations into melanoma and its causes.

An improved understanding of why people get melanoma can potentially lead to improved interventions to reduce the impact of melanoma in the community, as well as advances in the detection, treatment and management of the disease.

There are several components to the study, which are detailed below.

Questionnaire

This component of the study seeks to identify environmental factors that may affect melanoma severity and progression. Originally the questionnaire was divided into two parts - a self-administered questionnaire and a telephone interview. However, these have now been combined into one telephone interview.

The telephone interview asks about:

• Colouring
• Skin type
• Moles
• Lifestyle history
• Demography
• Family history
• Medical history
• An overview of lifetime sun exposure

Blood samples

Information from this component of the study aims to assess genetic factors that may affect melanoma susceptibility, severity and progression. It will also be used to assess genetic factors involved in the severity and progression of scarring. Blood samples are collected for extraction of:

• DNA
• RNA
• Serum

DNA samples will enable researchers to look at potential genes involved in melanoma and scarring.

RNA samples will be used in gene expression studies, to allow researchers to look at the proteins expressed by potential genes involved in melanoma and scarring.

Serum samples will be used for biochemical analyses.

Scar examination

The scar examination component forms a sub-study of the WAMHS. In collaboration with the McComb Foundation, the WAMHS will also investigate environmental and genetic factors affecting scar progression and healing in melanoma patients. As all participants in this study will have surgical scars it provides an excellent opportunity to investigate the treatment of melanoma in this cohort, in terms of establishing the natural history of the scar process.

An enhanced understanding of factors that contribute to poor scar outcomes could lead to advances in scar management, and ideally scarless healing, for not only melanoma patients but any patient who undergoes a procedure that involves scar formation.

Data for this part of the study is collected from:

Pathology reports

Information is collected about:

• Location of previous melanomas
• Excision details of melanoma of interest
• Lesion size of melanoma of interest

Questionnaire

A short self administered questionnaire that participants complete when they attend the scar examination, asking about:

• Relevant medical history
• Medications
• Melanoma excision
• Scar Management
• Adjuvant melanoma treatment
  

Scar examination

A visual scar examination, where the examiner grades the scar on:

• Size
• Vascularity
• Pigmentation
• Pliability
• Height

Additional measurements

A digital photograph is also taken of the scar to allow standardisation of visual examination and comparison of the scar over time.

A digital photograph of the participant's back is also taken at this time, to facilitate a mole count by researchers at a later date.

Measurements are taken with a reflectometer to obtain more accurate information about participant's skin colour, and with a tonometer to gain objective measurements of scar pliability.

The scar examination and photographs are repeated at a follow up session a year after the first examination.

From 2009 onwards, Optical Coherence Tomography (OCT)  measurements will also be taken, in collaboration with the Optical and Biomedical Engineering Laboratory. OCT is a non-invasive imaging technique that has the potential to provide quantitative parameters for assessing scars and human skin.

Study Process