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New recommendations needed for melanoma screening

Citing a 1-year pilot skin cancer-screening program in Germany, three dermatologists recommended that federal health officials make new recommendations for melanoma screening.

Under the national screening program that took place in Schleswig-Holstein, Germany, from 2003 to 2004, people 20 years or older with statutory health insurance were eligible for skin examination, according to an editorial by June K. Robinson, MD, and colleagues.

If the nondermatologist found a suspicious lesion, the patient was then referred to a dermatologist.

The program resulted in an increase in melanoma and nonmelanoma incidence of approximately 30%, as well as lower mortality rates than the unscreened regions, for the first time since 1980. As a result of the screenings, the mortality rate in Northern Germany decreased by 50%. The program also led to more early and small melanomas being detected, with nearly 90% of lesions detected being less than 1 mm in depth, according to the authors.

As a result of this screening program, a national screening program was implemented in Germany if 2008 that allowed people 35 years and older to receive a free screening every 2 years.

“Implementation of a melanoma screening program for high-risk patients 35 years or older could benefit individuals and provide useful evidence to determine whether screening younger populations is cost-effective and sustainable,” the authors wrote.

In order to make a similar screening program work in the United States, orchestrated efforts by specially trained medical personnel — including primary care physicians, physicians’ assistants and nurse practitioners — as dermatologists alone would be unable to meet such a demand, according to the authors.

The U.S. Preventive Services Task Force chose not to recommend routine primary care physician screening for skin cancer in 2009, citing insufficient evidence for such a recommendation; however, studies have since been published demonstrating the benefits of these screenings.

As such, “It is time for federal health officials and policy-making bodies to evaluate the current evidence and make new recommendations for melanoma screening,” the authors wrote.

Disclosure: The authors have no relevant financial disclosures.