Does skin cancer screening save lives?

Abstract

a population-based skin cancer screening project was conducted in SchleswigHolstein, Germany. In total, 360,288 individuals aged !20 years were screened by means of a whole-body examination. In this report, the authors compare trends in melanoma mortality in Schleswig-Holstein with those in all adjacent regions, none of which had population-based skin cancer screening. METHODS: Trends in melanoma mortality rates for Schleswig-Holstein and the adjacent regions (Denmark and the German federal states of Mecklenburg-Vorpommern, Hamburg, and Lower Saxony) and in Germany excluding Schleswig-Holstein were compared. Log-linear regression was used to assess mortality trends. RESULTS: In Schleswig-Holstein during the pre skin cancer screening period (1998)(1999), the age-standardized melanoma mortality rate (World standard population) was 1.9 per 100,000 for men and 1.4 per 100,000 for women. Melanoma mortality declined by 47% to 1.0 per 100,000 men and by 49% to 0.7 per 100,000 women by 2008/2009. The annual percentage change in the most recent 10-year period (2000-2009) was À7.5% (95% confidence interval, À14.0, À0.5) for men and À7.1% (95% confidence interval, À10.5, À2.9) for women. In each of the 4 adjacent regions and in the rest of Germany, mortality rates were stable, and the decline in Schleswig-Holstein was significantly different from the changes observed in all of the other areas studied. CONCLUSIONS: The current data represent strong evidence, but not absolute proof, that the skin cancer screening program produced a reduction in melanoma mortality in Schleswig-Holstein.

Computer-aided classification of melanocytic lesions using dermoscopic images

“…10 In addition, population-based screening performed primarily by nondermatologists can lower melanoma mortality. 11 This provides an opportunity to aid clinicians, particularly nondermatologists, by providing them an accessible tool to improve early detection of melanoma by aiding them in choosing lesions that are appropriate for biopsy. In developing our classifier, we considered how it may ultimately and practically be incorporated into a tool that can be widely and inexpensively used by a variety of health care practitioners.…”

A 10-Year Follow-Up Study of Subjects Recruited in a Health Campaign for the Early Diagnosis of Cutaneous Melanoma: Suggestions for the Screening Timetable

“…This figure is numerically higher, but non-significantly different from the percentage we found in the first phase of our study (15 out of 3,635; 0.41%). On the other hand, a much larger, population-based, skin cancer screening project was conducted in Schleswig-Holstein, Germany [29]. In total, 360,288 individuals were screened by means of a whole-body examination, and 585 individuals were diagnosed with cutaneous melanoma.…”

Are All Screening Programmes Created Equal? The Case of Melanoma

“…As a consequence, many expert bodies such as the United States Preventive Services Task Force did not find sufficient evidence to recommend skin cancer screening of the general population [7]. More recently, large-scale, observational studies, particularly the SCREEN programme conducted in Germany, have added new evidence that integration of skin examination into a routine physical assessment by a primary care physician, followed by referral of selected cases to a dermatologist, may be an effective strategy in reducing skin cancer mortality [8]. Statistical models have also been produced to identify individuals at higher risk of melanoma.…”