Does Assessment of Family History of Melanoma Provide Valid Information?

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Abstract
The objectives of this study were to determine the presence of bias in the assessment of the family history of melanoma and its possible influence on the estimate of the association of dysplastic nevi with family history of melanoma. The authors attempted to confirm a positive family history obtained in the context of a case-control, study of dysplastic nevi. Patients were members of a large health maintenance organization (HMO) who were diagnosed with a dysplastic nevus or melanoma by histopathological examination of an excised skin lesion. Two control groups were used: (1) general controls randomly selected from the HMO membership, and (2) dermatologic controls randomly selected among HMO patients not seen for a sun-related or nexus-related diagnosis. Controls were individually matched to cases by age and sex. The final sample included 722 patient/general control–matched pairs and 451 complete patient/general control/dermatologist control triads (which contained 369 patients with dysplastic nevi and 82 with melanoma). Each patient was asked, "Has anyone in your family ever had a melanoma?" Positive responses from patients and controls were confirmed by telephone with affected family members and by reviewing the medical records of those family members who confirmed a history of melanoma. Melanoma history was considered "contradicted" when either a family member denied having a melanoma history or the pathology report did not confirm the diagnosis. Negative histories of melanoma were not further verified.

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