More excisions performed on younger patients, but fewer malignant tumors identified

Issue: August 10, 2012

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

Researchers in Germany conducted a population-based skin cancer screening intervention that provided free, whole-body examinations of 360,288 participants aged 20 years or older 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.

The researchers stratified their findings for frequency of excisions, as well as yield of malignant melanomas, basal cell carcinomas and squamous cell carcinomas, by age and gender.

According to the results, 15,983 excisions were performed and 3,103 malignant skin tumors were confirmed, including 1,961 basal cell carcinomas, 585 malignant melanomas, 392 squamous cell carcinomas and 165 other malignancies.

The ratio of histopathologically confirmed malignant melanomas 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,” the researchers 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.”

Reference:

Waldmann A. Arch Dermatol. 2012;doi:10.1001/archdermatol.2012.893.