UniSA’s new training model enables nurses to fight skin cancer on the front line

UniSA has investigated the elevated skin cancer risk in remote communities while launching a targeted nurse-led skin check service in rural and regional South Australia. The service is now being trialled in prison health and has been adopted by industry giants like BHP.  

More than 1400 Australians will die each year from skin cancer by 20301. That’s more than 7000 skin cancer deaths in the next five and a half years2. It’s the stark reality we face if early intervention is not significantly improved.  

Even with significant investment in prevention campaigns, skin cancer rates are increasing, with more than 60% of Australians being diagnosed with skin cancer within their lifetime3.  

Despite these alarming statistics, Australia does not have a population-wide skin cancer screening program. 

This issue is compounded by an acute shortage of GPs in regional and remote areas4, where residents have 15–31% higher rates of skin cancer than the average Australian5.

Caption: UniSA experts discovered that nearly a quarter of regional and remote patients had a higher-than-average risk for melanoma, with a similar percentage facing elevated risks for keratinocyte cancers. 

Addressing the need for early skin cancer detection is a primary focus of the University of South Australia’s Rosemary Bryant AO Research Centre (RBRC).  

RBRC has recognised that nurses working in regional and remote locations are ideally positioned to conduct skin checks and support continuity of care for their communities. 

Accordingly, RBRC has launched a nine-week skin assessment training program, called ‘Project Check Mate’, a partnership between UniSA's RBRC, The Hospital Research Foundation Group, Skin Check Champions, Skin Smart Australia and, more recently, Preventive Health SA.

The skin assessment training program has upskilled regional and rural nurses, allowing them to conduct skin check appointments in six regional communities across South Australia.  

RBRC researchers have gained further insight into skin cancer risks in remote parts of Australia.

Caption: UniSA's RBRC has launched a nine-week training program, where nurses have been taught to perform dermoscopic skin assessments and to apply artificial intelligence (AI) medical photography as a learning tool. 

South Australia’s Professor of Cancer Nursing and RBRC Director, Marion Eckert, says her team has discovered that approximately a quarter of patients were at high-risk for melanoma.  

“We used the validated risk calculator for skin cancer when screening close to 1000 members of regional communities across South Australia,” Prof Eckert says.  

“Nearly a quarter of participants were found to be at higher-than-average risk for melanoma, with a similar percentage facing elevated risks for keratinocyte cancers. 

“We also identified a key contributing factor to this demographic’s elevated skin cancer risk: during screening appointments, more than 55% of regional community members said they had never had their skin checked. 

“We know that the early detection of skin cancer is vital to survival and a targeted skin cancer screening program has the real potential to increase survival rates. 

“Meanwhile, nearly 100% of participants expressed a desire to use the nurse-led service again, which demonstrates a strong trust in nurses as primary health care providers for targeted skin cancer screening.” 

Caption: Regional and remote Australians have 15–31% higher rates of skin cancer compared to the national average.

Throughout the nine-week skin assessment training program, nurses were taught how to perform dermoscopic skin assessments and how to apply artificial intelligence (AI) medical photography as a learning tool.  

As Prof Eckert explains, AI is used as a decision support tool, not as a diagnostic tool.  

“Once the nurses identify a suspicious lesion, they take a photo and the AI then analyses the image against its rich database, providing an innovative educational resource,” Prof Eckert says.  

“By using this technology in our training program, UniSA has launched regional South Australia’s first AI-based triage and decision-support model for nurses and GPs.”  

UniSA’s Project CheckMate has received significant attention from the community, as well as the government and private sector. 

Now, industry giant BHP has adopted UniSA’s training model to upskill its own on-site nurses at Carrapateena. 

Caption: UniSA's dermoscopic training model has been adopted by BHP, which has used the educational program to upskill on-site nurses at its Carrapateena site in SA. The nurses can now incorporate regular skin checks into standard health appointments while also tracking changes to workers' skin.

BHP’s Carrapateena Superintendent of Health & Emergency Services, Raf Sciezka, says Project CheckMate has already “paid dividends”. 

“We have a very stable workforce, meaning a lot of our people have worked here at BHP for a long period of time, so the training received through Project CheckMate now allows our nurses to track changes in our workers’ skin,” Sciezka says.  

“It also means our nursing staff can build mole maps of our workers and paint a more holistic picture of their skin health. 

“Already, our nurses have identified some workers on our site as having ‘high risk’ lesions and these workers have been quickly referred on to doctors.”  

BHP Carrapateena Nurse, Sonya Russ, says the training has enhanced her professional development while enabling her to deliver a life-saving service. 

“In the course of my workday, if I see a suspicious lesion, I will have a better understanding of what I'm seeing and be able to make informed recommendations to my patient,” Russ says.  

“It will allow our nursing team to run in-house skin check clinics throughout the year on as both appointment-based or as pop-up clinics for the workforce here at Carrapateena. 

“Now, we will be able to incorporate this into our care pathway and offer skin checks ad-hoc rather than during dedicated times.” 

 Learn more about the Rosemary Bryant AO Research Centre.

[1] State of the Nation, A Report Into Melanoma
[2] State of the Nation, A Report Into Melanoma
[3] About skin cancer, Cancer Council NSW
[4] Regional and remote Australia most at risk as report warns of worsening GP shortfall
[5] Cancer Statistics for Small Geographic Areas, AIHW 2019