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Younger patients showed more excisions, fewer malignant skin tumors

Screenings for skin cancer resulted in a higher number of excisions performed on younger participants with an associated lower yield of malignant tumors, according to recent study results.

Researchers in Germany conducted a population-based skin cancer screening intervention called the SCREEN project that provided free, whole-body examinations of 360,288 participants in the state of Schleswig-Holstein. The 1-year study, believed to the largest of its kind worldwide, took place in physicians’ offices where participants chose between dermatologists and nondermatologist physicians. All screening physicians received an 8-hour mandatory training course before examining patients, aged 20 years or older.

The researchers stratified their findings for frequency of excisions, yield of malignant melanomas (MM), basal cell carcinomas (BCC) and squamous cell carcinomas (SCC) by age and gender. Among the data: 15,983 excisions were performed, and 3,103 malignant skin tumors were confirmed, including 1,961 BCC, 585 MM, 392 SCC and 165 other malignancies.

The ratio of histopathologically confirmed MM to the number of excisions was 1:28 in women and men. In men aged 65 years and older, data showed that 20 excisions were performed for every one malignant melanoma detected, while in men aged 20 to 49 years, the ratio was more than 50 to 1 for lesions excised vs. malignant melanomas.

“We report a high number of excisions for few confirmed skin cancers in young screenees,” investigators concluded. “Future screening activities may, therefore, benefit from improved training of the physicians regarding selection of lesions requiring excisions. Specifically, we suggest adapting the training curriculum toward a more conservative attitude toward excisions in young screenees.”