DOI: 10.3310/nihropenres.14348.1 ISSN: 2633-4402

Development and Validation of the Melanoma Cancer Awareness Measure

Liz Wilson, Oliver Nix, Monika Janda, H. Peter Soyer, Samuel G. Smith, Sophie M. C. Green
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Background In the UK, the time taken to recognise a melanoma symptom and seek medical attention is the third longest of all cancers. There is no validated measure to assess public awareness of melanoma. We aimed to develop and validate a reliable Melanoma Cancer Awareness Measure (M-CAM). Methods Items for symptoms and risk factors were sourced from national cancer guidelines and patient information websites and reviewed by an expert panel. Three validation studies were undertaken. To assess internal and test-retest reliability, the general public (n = 32) completed the M-CAM on two occasions (~14 days apart). Construct validity was assessed by comparing expert (n = 35) and the general public (n = 100) responses. Sensitivity to change was established by comparing responses of participants randomly allocated to a control leaflet (n = 32) or a melanoma leaflet (n = 29). Results Internal reliability was high (Cronbach’s alpha>0.8) for all scales. Public responses were consistent over time, demonstrating test-retest reliability. Experts achieved higher scores than the general public on prompted [11.26(2.70) vs 9.10(3.25),p < 0.001] and unprompted symptom awareness items [3.06(1.81) vs 1.67(1.68),p < 0.001], and unprompted risk factor items [1.26(1.22) vs 0.81(0.95),p = 0.053]. However, prompted risk factor items scores were not different between the groups [10.69(6.07) vs 10.74(4.62),p = 0.422]. The melanoma leaflet group performed better than the control group in the prompted symptom [12.59(1.84) vs 9.75(3.57), p < 0.001], unprompted symptom [4.55(2.08) vs 1.84(1.44),p < 0.001], prompted risk factor [15.59(3.49) vs 12.06(4.40),p < 0.001] and unprompted risk factor items [2.14(1.73) vs 0.87(1.04),p = 0.007] demonstrating the measure is sensitive to change. A risk factor item related to age did not demonstrate construct validity or sensitivity to change. Conclusions The M-CAM is a reliable and valid tool to assess melanoma symptom awareness. Further validation may be needed to assess construct validity of the risk factor subscale. Assessing awareness of melanoma in national surveys could identify gaps in knowledge and support early detection and awareness efforts.

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