Participation and health care provision of statutory skin cancer screening in Germany – a secondary data analysis

Sorbe

et al. 2020

Acad Dermatol Venereol

Self Cite

Background Due to the increasing incidence of skin cancer, programmes for the prevention of skin cancer have been developed and implemented in Germany. However, utilization of skin cancer screenings shows marked regional differences. Reasons and predictors of such variations are unclear. Objectives The objective of the study is to identify predictors for regional use of skin cancer screening variations in Germany. Methods Analysis of the population set of ambulatory claims data (2009-2015) of the statutory health insurances (SHI) in Germany (70.2 million people in 2015). Skin cancer screening utilization rate was determined on county level. Descriptive, cluster and multivariate analyses were performed to identify spatial patterns in skin cancer screening utilization. Results Overall, 6.5-7.9 million people participated in skin cancer screenings. Utilization rates of people ≥35 years of age were 9.74% (2009) and 10.96% (2015). Marked regional variations were identified between the counties. Dermatologists in Saxony and Westphalia-Lippe as well as general practitioners in Lower Saxony and North Rhine showed particularly high utilization rates. Multiple regression analyses demonstrated e.g. positive associations between the skin cancer screening utilization rates and employees with higher vocational qualifications and shorter travel time by car to the nearest major urban centre. Conclusion Utilization rates of skin cancer screening vary largely in Germany with specific spatial patterns. Multivariate analyses demonstrate associations with socioeconomic and geographical determinants. The results indicate the importance of health policy measures. These should be used in a more targeted manner in the regions in order to increase utilization of skin cancer screening.

Section: Introductionmentioning

confidence: 99%

Regional variations in the use of statutory skin cancer screenings in Germany: population‐based spatial multisource analysis

Sorbe

et al. 2020

Acad Dermatol Venereol

Self Cite

“…shown that utilization of such strategies is not highly prevalent (21)(22)(23), particularly among individuals who spend a lot of time outdoors (24)(25)(26)(27).…”

mentioning

confidence: 99%

Interest in Skin Cancer in Urban Populations: A Retrospective Analysis of Google Search Terms in Nine Large German Cities

Tizek¹,

Schielein²,

Rüth³

et al. 2019

Acta Derm Venerol

This study examined the Google search volume for skincancer-related terms in 9 German cities. Overall, 3.5 million searches related to skin cancer were observed between July 2014 and June 2018. Most of these searches focused on the identification of skin cancer (e.g. ABCD and pictures of skin cancer). In general, the number of search queries per 100,000 inhabitants was lower in larger cities, such as Berlin or Hamburg, in comparison with Stuttgart or Muenster. Analysis of the differences in search behavior between cities could help to identify areas with a high need for targeted prevention campaigns. Skin cancer is a major public health issue, which could be reduced through prevention programmes. How ever, prevention utilization is not very prevalent. It is therefore important to understand individuals' interest in skin cancer. Google AdWords Keyword Planner was used to identify the search volume of terms relating to skin cancer in 9 German cities between July 2014 and June 2018. From a total of 1,203 identified keywords, 1,047 search terms were related to skin cancer, which had a search volume of 3,460,980 queries for the study period. Most terms referred to "identifying skin can cer". For melanoma, the number of Google searches per 100,000 inhabitants correlated with the cancer registry data for melanoma incidence rates (men: r = 0.810, women: r = 0.569). Assessment of this data for the different cities further enabled identification of regional variations, which could help to identify areas with a high need for targeted prevention campaigns.

“…However, over 50% of mountain guides reported sunburn experience within the last year, implying that sun protection in mountain guides is inadequate and needs to be improved. 38,39 Previous efforts as reported above for primary prevention 14-17 may have contributed to the increased prevalence of skin cancer screening. The findings of our study for secondary prevention are consistent with previous studies in mountain guides: about 66% of mountain guides in this study had never attended a skin cancer screening before, compared to about 50% in other studies.…”

Section: Discussionmentioning

confidence: 96%

“…34 Today, 10 years after the introduction of compulsory skin cancer screening in Germany (in 2008), 24 about one-third of the eligible general population has undergone at least one skin cancer screening. 38,39 Previous efforts as reported above for primary prevention 14-17 may have contributed to the increased prevalence of skin cancer screening. However, the rate of screening is yet inadequate considering the high prevalence of NMSC (including actinic keratosis) of about 40% in mountain guides 14,16 ; it is important to note that our data show that 40% of participants consider themselves insufficiently informed about skin cancer and skin cancer screening.…”

Section: Discussionmentioning

confidence: 96%

Primary and secondary prevention of skin cancer in mountain guides: attitude and motivation for or against participation

Zink

Thomé

Schielein

et al. 2018

Acad Dermatol Venereol