Skin cancer screening participation and impact on melanoma incidence in Germany--an observational study on incidence trends in regions with and without population-based screening |
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Authors: | Waldmann A Nolte S Weinstock M A Breitbart E W Eisemann N Geller A C Greinert R Volkmer B Katalinic A |
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Institution: | University Hospital Schleswig-Holstein, Campus Luebeck, Institute of Clinical Epidemiology, Ratzeburger Allee 160, 23562 Luebeck, Germany. Annika.Waldmann@uksh.de |
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Abstract: | Background: The SCREEN (Skin Cancer Research to provide Evidence for Effectiveness of Screening in Northern Germany) project involved population-wide skin cancer screening with whole-body examination by general physicians and dermatologists. It was conducted in the German state of Schleswig-Holstein (July 2003–June 2004), but not in the German state of Saarland.Methods: The population-based registries of Schleswig-Holstein and Saarland provided data on melanoma incidence before, during, and after SCREEN to assess the association of skin cancer screening with incidence.Results: Approximately 19% of the Schleswig-Holstein population participated in SCREEN (women: 27%, men: 10%). A total of 52% of all melanomas diagnosed during SCREEN in Schleswig-Holstein were detected as part of the project. Melanoma incidence increased during SCREEN (invasive melanoma in women: +8.9 per 100?000 (95% confidence intervals (CI): 6.1; 11.7); men: +4.0 per 100?000 (95% CI: 1.6; 6.4)) and decreased afterwards (women: ?10.6 per 100?000 (95% CI: ?13.3; ?7.9); men: ?4.1 per 100?000 (95% CI: ?6.5; ?1.7)). Similar changes were not observed in Saarland that had no such project. The differences between the two states were greatest among women, the group with the greater SCREEN participation.Conclusion: The SCREEN project had a substantial impact on melanoma incidence. This is consistent with the impact of effective screening for other cancers. |
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Keywords: | skin neoplasms mass screening incidence melanoma epidemiologic studies |
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