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Original Investigation
June 2018

Interest and Uptake of MC1R Testing for Melanoma Risk in a Diverse Primary Care Population: A Randomized Clinical Trial

Author Affiliations
  • 1Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
  • 2Clinical Research Finance, Memorial Sloan Kettering Cancer Center, New York, New York
  • 3Division of Epidemiology, Department of Internal Medicine, University of New Mexico, Albuquerque
  • 4Department of Communication, University of Utah, Salt Lake City
  • 5Huntsman Cancer Institute, University of Utah, Salt Lake City
  • 6New Mexico Translation and Transcription, Albuquerque
  • 7CRTC Population Sciences Academic Unit, University of New Mexico, Albuquerque
  • 8Department of Family and Community Medicine, University of New Mexico, Albuquerque
  • 9Center for Mind and Body Health, PLLC, Charlottesville, Virginia
  • 10Department of General Internal Medicine, University of New Mexico, Albuquerque
  • 11Department of Anthropology, University of New Mexico, Albuquerque
  • 12Klein Buendel Inc, Golden, Colorado
  • 13Department of Internal Medicine, University of New Mexico, Albuquerque
  • 14Department of Dermatology, University of New Mexico, Albuquerque
JAMA Dermatol. 2018;154(6):684-693. doi:10.1001/jamadermatol.2018.0592
Key Points

Question  What are the prevalence and patterns of interest in MC1R testing in a diverse, primary care population?

Findings  In this randomized clinical trial that included 499 adults receiving an invitation to consider MC1R testing, nearly half logged on to the study website to consider testing; non-Hispanic whites and those with higher educational attainment were most likely to be interested in testing, compared with Hispanics and those with lower educational attainment.

Meaning  Genetic testing for common variation in skin cancer risk may be acceptable in the general population; addressing potential for reduced utilization in minority and less educated individuals may be warranted.


Importance  Germline variants in the MC1R gene are common and confer moderate melanoma risk in those with varied skin types. Approaches to precision skin cancer prevention that include genetic information may promote risk awareness and risk reduction in the general population, including Hispanics.

Objective  To examine prevalence of interest in and uptake of MC1R testing in the general population and examine patterns across demographic and skin cancer risk factors.

Design, Setting, and Participants  A randomized clinical trial examined interest in and uptake of MC1R testing among patients at University of New Mexico General Internal Medicine clinics. Study participants were randomized to either a usual-care condition (National Cancer Institute skin cancer pamphlet for diverse skin types) or an MC1R test offer. Participants were registered clinic patients (≥6 months) and English or Spanish fluent. Of the 600 participants recruited to the overall trial, the present study included those 499 participants randomized to the MC1R test offer.

Interventions  Participants were presented with the option to log onto the study website to read 3 educational modules presenting the rationale, benefits, and drawbacks of MC1R testing.

Main Outcomes and Measures  Main outcomes include website log on (yes vs no), saliva test kit request (yes vs no), and saliva test kit return for MC1R testing (yes vs no). Demographic and skin cancer risk factors were examined as potential predictors of test interest and uptake.

Results  Of the 499 participants (220 [44%] non-Hispanic white, 242 [48%] Hispanic, 396 [79%] female; mean [SD] age, 54 [14.3] years), 232 (46%) elected to learn about MC1R testing by logging onto the website; 204 (88%) of those who logged on decided to request testing; and 167 (82%) of those who requested testing returned the kit. The strongest predictors of website log on were race/ethnicity and education (non-Hispanic whites were more likely to log on [odds ratio for Hispanics vs non-Hispanic whites, 0.5; 95% CI, 0.3-0.7], as were more highly educated individuals [odds ratio for more than high school vs high school or less, 2.7; 95% CI, 1.7-4.3]). The strongest predictor of ordering the test was sunburn history (odds ratio, 5.4; 95% CI, 2.3-12.9 vs no sunburn history).

Conclusions and Relevance  There were moderately high levels of MC1R test interest and uptake in this diverse sample. Addressing potential barriers to testing may be warranted as genomic information becomes integrated into general population approaches to the precision prevention of skin cancer.

Trial Registration  ClinicalTrials.gov identifier: NCT03130569