Self-assessment of melanoma risk factors versus expert assessment: A systematic review of agreement

Abstract

The number of melanoma cases has been rising over the past decades. Hence, screening is essential to provide early and effective patient management. However, screening for risk factors binds medical resources and may be conducted by patients. To evaluate the quality and validity of such a self-assessment, a systematic review of patient-expert agreement in dermatologic examinations is presented. A systematic review of studies examining participant-expert agreement on melanoma risk factors that were published until May 2025 was conducted. Included sources were retrieved from PubMed, the Web of Science Core Collection, and Scopus. Publications in languages other than English were excluded from the analysis. Of the 3562 records identified, 29 were eligible for evaluation. Six melanoma risk factors dominated the results: Typical and atypical nevi, skin phototype, freckles, hair and eye color., with typical nevi being the most frequently assessed risk factor (22 studies). Agreement is highly heterogeneous, ranging from predominantly weaker to scarcely reported substantial agreement, casting doubts on whether individuals should be tasked with self-assessment. Individual self-assessment may currently serve as a first indication of elevated melanoma risk but cannot substitute for dermatologic screening.

Keywords: Agreement; Melanoma; Nevi; Risk factors; Self-assessment.