Achieving Self-Directed Integrated Cancer Aftercare (ASICA) in melanoma: Protocol for a randomised patient-focused pilot trial of delivering the ASICA intervention as a means to earlier detection of recurrent and second primary melanoma

Peter Murchie* (Corresponding Author), Judith Masthoff, Fiona M. Walter, Kazi Rahman, Julia L. Allan, Nigel Burrows, Charlotte Proby, Amanda J. Lee, Marie Johnston, Amer Durrani, Ivan Depasquale, Billy Brant, Aileen Neilson, Fiona Meredith, Shaun P. Treweek, Susan J. Hall, Alison M. McDonald

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)
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Melanoma is common; 15,906 people in the UK were diagnosed with melanoma in 2015 and incidence has increased fivefold in 30 years. Melanoma affects old and young people, with poor prognosis once metastatic. UK guidelines recommend people treated for cutaneous melanoma receive extended outpatient, hospital follow up to detect recurrence or new primaries. Such follow up of the growing population of melanoma survivors is burdensome for both individuals and health services. Follow up is important since approximately 20% of patients with early-stage melanoma experience a recurrence and 4–8% develop a new primary; the risk of either is highest in the first 5 years. Achieving Self-directed Integrated Cancer Aftercare (ASICA) is a digital intervention to increase total-skin-self-examination (TSSE) by people treated for melanoma, with usual follow up.


We aim to recruit 240 adults with a previous first-stage 0-2C primary cutaneous melanoma, from secondary care in North-East Scotland and the East of England. Participants will be randomised to receive the ASICA intervention (a tablet-based digital intervention to prompt and support TSSE) or control group (treatment as usual). Patient-reported and clinical data will be collected at baseline, including the modified Melanoma Worry Scale (MWS), the Hospital Anxiety and Depression Scale (HADs), the EuroQoL 5-dimension 5-level questionnaire (EQ-5D-5 L), and questions about TSSE practice, intentions, self-efficacy and planning. Participants will be followed up by postal questionnaire at 3, 6 and 12 months following randomization, along with a 12-month review of clinical data. The primary timepoint for outcome analyses will be12 months after randomisation.


If the ASICA intervention improves the practice of TSSE in those affected by melanoma, this may lead to improved psychological well-being and earlier detection of recurrent and new primary melanoma. This could impact both patients and National Health Service (NHS) resources. This study will determine if a full-scale randomised controlled trial can be undertaken in the UK NHS to provide the high-quality evidence needed to determine the effectiveness of the intervention. ASICA is a pilot study evaluating the effectiveness of the practice of digitally supported TSSE in those affected by melanoma.

Trial registration

Clinical, NCT03328247. Registered on 1 November 2017.

Original languageEnglish
Article number318
Number of pages11
Publication statusPublished - 3 Jun 2019

Bibliographical note

The authors gratefully acknowledge Joanna Kaniewska, Anne Duncan and Lynda Constable (trial management) for their contributions to the protocol and management of the study.

The study is supported by a grant from a Cancer Research UK Population Research Committee project award (C10673/A21685). The views and opinions expressed herein are those of the authors and do not necessarily reflect those of Cancer Research UK. The funder (through their peer review and funding board review process) approved the study proposal but had no role in the collection, analysis, or interpretation of data, or writing of the report.


  • primary care
  • melanoma
  • cancer
  • randomised controlled trial
  • survivorship
  • self-directed care
  • e-health
  • Self-directed care
  • Melanoma
  • Survivorship
  • Primary care
  • Randomised controlled trial
  • Cancer


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