A pilot study of a telehealth family-focused melanoma preventive intervention for children with a family history of melanoma

Proposing a hybrid technique of feature fusion and convolutional neural network for melanoma skin cancer detection

Skin cancer is among the most common cancer types worldwide. Automatic identification of skin cancer is complicated because of the poor contrast and apparent resemblance between skin and lesions. The rate of human death can be significantly reduced if melanoma skin cancer could be detected quickly using dermoscopy images. This research uses an anisotropic diffusion filtering method on dermoscopy images to remove multiplicative speckle noise. To do this, the fast-bounding box (FBB) method is applied here to segment the skin cancer region. We also employ 2 feature extractors to represent images. The first one is the Hybrid Feature Extractor (HFE), and second one is the convolutional neural network VGG19-based CNN. The HFE combines 3 feature extraction approaches namely, Histogram-Oriented Gradient (HOG), Local Binary Pattern (LBP), and Speed Up Robust Feature (SURF) into a single fused feature vector. The CNN method is also used to extract additional features from test and training datasets. This 2-feature vector is then fused to design the classification model. The proposed method is then employed on 2 datasets namely, ISIC 2017 and the academic torrents dataset. Our proposed method achieves 99.85%, 91.65%, and 95.70% in terms of accuracy, sensitivity, and specificity, respectively, making it more successful than previously proposed machine learning algorithms.

The Family Lifestyles, Actions and Risk Education (FLARE) study: Protocol for a randomized controlled trial of a sun protection intervention for children of melanoma survivors

BACKGROUND

Children of parents who had melanoma are more likely to develop skin cancer themselves owing to shared familial risks. The prevention of sunburns and promotion of sun-protective behaviors are essential to control cancer among these children. The Family Lifestyles, Actions and Risk Education (FLARE) intervention will be delivered as part of a randomized controlled trial to support parent-child collaboration to improve sun safety outcomes among children of melanoma survivors.

METHODS

FLARE is a two-arm randomized controlled trial design that will recruit dyads comprised of a parent who is a melanoma survivor and their child (aged 8-17 years). Dyads will be randomized to receive FLARE or standard skin cancer prevention education, which both entail 3 telehealth sessions with an interventionist. FLARE is guided by Social-Cognitive and Protection Motivation theories to target child sun protection behaviors through parent and child perceived risk for melanoma, problem-solving skills, and development of a family skin protection action plan to promote positive modeling of sun protection behaviors. At multiple assessments through one-year post-baseline, parents and children complete surveys to assess frequency of reported child sunburns, child sun protection behaviors and melanin-induced surface skin color change, and potential mediators of intervention effects (e.g., parent-child modeling).

CONCLUSION

The FLARE trial addresses the need for melanoma preventive interventions for children with familial risk for the disease. If efficacious, FLARE could help to mitigate familial risk for melanoma among these children by teaching practices which, if enacted, decrease sunburn occurrence and improve children's use of well-established sun protection strategies.

Parent and child perspectives on family interactions related to melanoma risk and prevention after CDKN2A/p16 testing of minor children

Predispositional genetic testing of children for adult-onset health risks is typically only used when prevention and screening measures have utility during childhood. Little is known about how children and their parents may use predispositional risk information, including whether it changes their interactions around risk-reducing prevention and screening behaviors. The current study examined perspectives on family interactions around skin cancer prevention and control practices through 1 year after test reporting and counseling among children who received melanoma predispositional genetic testing and their parents. Eighteen children (50% carriers, 56% male, mean age = 12.4 years) and 11 parents from 11 families participated in semi-structured interviews 1 month and 1 year after receiving the child's test result. Both parents (73%) and children (50%) reported making changes to family skin cancer prevention and control practices after receiving the test result. Parent- and child-reported discussions about melanoma prevention increased over time (36% parents and 61% children at 1 month, 73% parents and 67% at 1 year). One-quarter (27%) of parents and no children reported having conflicts about sun protection or screening 1 year after test reporting. A majority of parents (63%) reported treating their child differently at the 1-year follow-up, especially among carriers. Predispositional genetic testing for melanoma was associated with reported changes to plans for and discussions about sun protection, and high levels of parent-child collaboration to implement child sun protection. Future work could seek to identify child and parent factors and interactions that predict improved prevention and screening behaviors following pediatric predispositional genetic testing.