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Organized Melanoma Screening Proven Effective in German Study

Trials to test the effectiveness of organized skin cancer screening are very expensive and most countries are unable to investigate the positive potential such screenings would have on diagnosis and mortality rates.  In Germany, however, variable compromise allowed the “Skin Cancer Research to Provide Evidence for Effectiveness of Screening in Northern Germany” (SCREEN) project to survey the effects of skin screening.  Their population-based study could be considered one of the most thorough studies of skin cancer screening to date.
Starting in July 2003, screening was offered to state-insured residents of Schleswig-Holstein above the age of 20 years old.  360,288 of the 1.8 qualifying residents were examined during a 1-year screening period.  Participants chose from two paths of screening.
Pathway A
77% participants were evaluated through this path.
Initial Evaluation: A nondermotologist is trained to screen for cancers.
+ 26% with suspicious lesions or high-risk family history
+ 37% of the 26% were unable to reach a dermatologist after initial referral 
Pathway B
57% of these participants were considered “at risk” for melanoma.
Initial Evaluation: Screening was conducted by dermotologist 
Results: 81,032 considered at risk
15,983 of former number were biopsied
18% of former number proved to have skin cancer
During SCREEN vs. Before SCREEN (2 years):
+ Invasive melanoma 16% higher in men during screening
+ Invasive melanoma 38% higher in women during screening
+ Tumor thickness less that 1mm in 90% of melanomas detected furing screening
+ Proportion of small tumors increased from 52% before to 64% after
+ Mortality rate dropped significantly 5 years after the SCREEN project.
What this study is saying
This analysis showed that population-based screening detected tumors in their earlier stage.  It was also noted that mortality rates decreased years after the screening period.  SCREEN project results should catalyze an increase in such studies in the future.
Source: Dermatology Journal Watch 
[Image by Niklas Bildhauer]


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