Barriers to Using a Nationwide Skin Cancer Screening Program: Findings from Germany

Abstract

Background: In 2008, a nationwide standardized and systematic skin cancer screening (SCS) service, which is globally unique, was implemented in Germany. We aimed to provide current data on SCS use, to explore barriers to SCS usage, and to identify population groups with lower rates of SCS use. Methods: We analyzed data from 2,635 participants (18-45 years) in the National Cancer Aid Monitoring on Sunbed Use. Data on SCS use, barriers to SCS, and sociodemographic characteristics were obtained. Chi-square tests and logistic regression analyses were performed to analyze the data. Data was weighted by age, sex, educational level, and federal state. Results: In total, 39.0% of participants reported having been screened for skin cancer at least once in their lifetime. The subjective importance of different barriers varied depending on the participants' educational level. SCS use was negatively associated with male sex (odds ratio (OR) = 0.63, p < 0.001), low level of education (OR = 0.83, not significant), immigrant background (OR = 0.63; p < 0.001), and having no employment. Conclusion: Although the SCS is part of the regular healthcare services offered in Germany, our data showed lower usage among certain population groups. Barriers relevant for these groups should be considered when developing measures to increase SCS use.

Does sunscreen use comply with official recommendations? Results of a nationwide survey in Germany

“…In Germany, a biannual skin cancer screening is part of the healthcare routine of insurants aged 35 and over. The lifetime prevalence of skin cancer screening use here is about 39% . In addition to the whole body skin examination, dermatologists and physicians, who are enabled to perform this screening, are supposed to counsel their patients on primary prevention of skin cancer.…”

Is the quality of skin cancer screening in Germany related to the specialization of the physician who performs it?: Results of a nationwide survey among participants of skin cancer screening

“…In the past, several studies have explored the use of SCS within the German population, both from the perspective of those who underwent SCS and based on evaluation of data from health insurance companies. These studies reported SCS participation rates to range between 28% and 40% 10‐14 . In addition, regional differences in access to SCS have been revealed 15 .…”

“…These studies reported SCS participation rates to range between 28% and 40%. [10][11][12][13][14] In addition, regional differences in access to SCS have been revealed. 15 One study focused on the provision of preventive counseling for skin cancer during SCS; however, the results were based on a relatively small sample size.…”

Barriers to access cancer‐related services for men in high‐income countries: A narrative review looking beyond socioeconomic disadvantages

“…9,10 In Germany for instance, several studies have reported on the underutilization of skin and colon cancer screening offers. [11][12][13][14] Gender-specific differences in cancer susceptibility are well known in cancer epidemiology. 15 Research shows that men are more likely to develop and die from cancer than women 3,15 , with only three types of cancers having a higher mortality rate in women than men.…”

“…Although cancer screening programs may effectively reduce the disease burden, utilization of available services remains low, even in high‐income countries with subsidized public healthcare systems 9,10 . In Germany for instance, several studies have reported on the underutilization of skin and colon cancer screening offers 11–14 …”