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. 2025 Jul 1;25(1):222.
doi: 10.1186/s12911-025-03074-9.

A systematic review of microsimulation models for skin cancer

Caroline G Watts #  1   2 , Kirstie G McLoughlin #  3 , Stephen Wade  3 , Amelia K Smit  3   4 , H Peter Soyer  5   6 , Pablo Fernandez-Peñas  7   8 , David C Whiteman  9   10 , Pascale Guitera  4   11   12 , Gillian Reyes-Marcelino  3   4 , Karen Canfell  11 , Anne E Cust #  3   4 , Michael Caruana #  11
Affiliations

A systematic review of microsimulation models for skin cancer

Caroline G Watts et al. BMC Med Inform Decis Mak. .

Abstract

Background: Simulation modelling can assist with health care decision making. To inform the development and improvement of skin cancer focussed microsimulation models, we conducted a systematic review and narrative synthesis of published skin cancer models to assess the structure, parameterisation, and assumptions.

Methods: The electronic databases OVIDMedline including Embase and the Cost-Effectiveness Analysis (CEA) Registry were searched up to 7 May 2025. Studies that included microsimulation of individuals who developed or had skin cancer were eligible for inclusion. No restrictions on publication date or language were applied. The outcomes of interest were the purpose of the models, characteristics of the models and applicability for modelling skin cancer screening.

Results: Twenty-two models were identified from the systematic review. Nineteen papers modelled melanoma, and two papers modelled keratinocyte or non-melanoma skin cancer, and one paper modelled both melanoma and keratinocyte cancer. The models were developed to assess treatment strategies (n = 10), skin cancer screening programs (n = 7), diagnostic techniques (n = 3), post-diagnosis surveillance (n = 3), preventative interventions (n = 1) and time to treatment (n = 1), with three models reporting dual aims. There was substantial variation in the simulation of the natural history of melanoma between models, with more recent models having separate natural history and clinical modules. The quality was assessed using the Quality Assessment Reporting for Microsimulation Models (QARMM) checklist and the majority of models were assessed to be of moderate quality. Limitations from these models included assuming an average tumour behaviour and constant melanoma development and progression over time. Data availability was also noted as a limitation for some models.

Conclusions: Most microsimulation models related to skin cancer have focused on late-stage treatment strategies. Tumour characteristics, apart from stage at diagnosis, were not accounted for in most models.

Prospero registration number: CRD42024504250.

Keywords: Health decision modelling; Melanoma; Microsimulation; Skin cancer.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: HPS is a shareholder of MoleMap NZ Limited and e-derm consult GmbH and undertakes regular teledermatological reporting for both companies. HPS is a Medical Consultant for Canfield Scientific Inc and a Medical Advisor for First Derm. The other authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
PRISMA diagram showing process of study selection. No additional articles were included from reference lists. Four papers referred to adapting earlier models which were included in the review
See this image and copyright information in PMC

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