Does skin cancer screening save lives?

An observational study comparing trends in melanoma mortality in regions with and without screening

Authors

  • Alexander Katalinic MD,

    Corresponding author
    1. Institute of Clinical Epidemiology, University Hospital Schleswig-Holstein, Campus Luebeck, Luebeck, Germany
    2. Institute of Cancer Epidemiology, University of Luebeck, Luebeck, Germany
    • Institute of Clinical Epidemiology, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany

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    • Fax: (011) 49 451 500 5455

  • Annika Waldmann PhD,

    1. Institute of Clinical Epidemiology, University Hospital Schleswig-Holstein, Campus Luebeck, Luebeck, Germany
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  • Martin A. Weinstock MD, PhD,

    1. Dermatoepidemiology Unit, Veterans Affairs Medical Center, Providence, Rhode Island
    2. Department of Dermatology, Rhode Island Hospital, Providence, Rhode Island
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  • Alan C. Geller MPH RN,

    1. Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, Massachusetts
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  • Nora Eisemann Dipl.-Stat.,

    1. Institute of Cancer Epidemiology, University of Luebeck, Luebeck, Germany
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  • Ruediger Greinert PhD,

    1. Association of Dermatological Prevention, Hamburg, Germany
    2. Elbe Clinics, Center of Dermatology, Buxtehude, Germany
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  • Beate Volkmer PhD,

    1. Association of Dermatological Prevention, Hamburg, Germany
    2. Elbe Clinics, Center of Dermatology, Buxtehude, Germany
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  • Eckhard Breitbart MD

    1. Association of Dermatological Prevention, Hamburg, Germany
    2. Elbe Clinics, Center of Dermatology, Buxtehude, Germany
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  • Implementation and conduct of the 12-month SCREEN project was supported by German Cancer Aid (Deutsche Krebshilfe e. V.), the National Association of Statutory Health Insurance Physicians (Kassenaerztliche Bundesvereinigung), and the head associations of health insurance funds (Spitzenverbaende der Krankenkassen).

  • A.K. planned the study, did the data collection and descriptive data analysis, and drafted the article. A.W. helped to draft the article and provided oversight for the literature review. M.A.W. and A.C.G. critically revised the article, contributed to the literature, and provided substantial input to the discussion. N.E. was responsible for the statistical analysis. R.G. and B.V. critically revised the article. E.B. coordinated the study group, contributed to the design of the study, and helped to interpret and write the article.

Abstract

BACKGROUND:

From July 1, 2003 to June 30, 2004, a population-based skin cancer screening project was conducted in Schleswig-Holstein, 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 −7.5% (95% confidence interval, −14.0, −0.5) for men and −7.1% (95% confidence interval, −10.5, −2.9) 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. Cancer 2012. © 2012 American Cancer Society.

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