SCARS – Skin Cancer Assessment Remote Service – Nurse led clinics

Miss Sheena Christensen1

1Silverchain, Walpole, Australia


Skin Cancer deaths in farmers 65yr + are double that of other Australians, with presentation so late that intervention is generally palliative. In 2012, the Australian Institute of Health and Welfare identified that: “a higher priority should be given to maximizing the expertise of health professionals in rural and remote areas including the early detection, early treatment, and management of skin cancer”. In 2014, the National Health Rural Alliance recommended: “people in rural and remote Australia should be recognized as a priority group”.

The Skin Cancer Assessment Remote Service (SCARS) was designed by Sheena Christensen (2017) following professional involvement in 2 devastating skin cancer cases: one a misdiagnosed invasive facial squamous cell carcinoma and another rare BRAF type melanoma and metastasis.

Silver Chain was identified as being able to play a key role in all matters aimed at the detrimental effects of sun exposure. The service, SCARS provide biannually, nurse led, qualified skin cancer screening to remote locations in WA. This includes individual comprehensive risk assessment, full body skin cancer screening with dermatoscopy and one to one education on skin cancer detection, skin self-examination (SSE), sun protection and how to locate skin cancer qualified health professionals. SCARs also provide community education sessions and upskilling of nurses.

The initial pilot service screened 54 patients in 4 days

  • 47% male and 53% female: 20% high risk and 79% medium risk for melanoma and NMSC.
  • 49% had no previous history of skin cancer screening-
  • 6 malignant melanomas have been excised, 8 lesions of varying types SCC and 7 lesions of varying types BCC have been professionally treated and managed.

The provision of nurse led clinics is a professional and effective program to address the early detection, early treatment and management of skin cancer in rural and remote Australia.


Remote Area Nurse Walpole Silverchain Primary Health WA – responsible to provide emergency nursing care, routine clinical assessments, domiciliary nursing care and plan and participate in Health Promotional activities.

Certificate in Primary Care Skin Cancer Medicine. (2016 University Qld and Healthcert)

Professional Certificate Dermoscopy (2017 Healthcert)

Advanced Certificate Dermoscopy (2018 Healthcert)

Professional Diploma Dermoscopy (2019 Healthcert)

Graduate Certificate Medicine – Skin Cancer (current 2019 University Qld)