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Four perspectives on skin cancer screening success
NEW YORK — Despite a 52% reduction in mortality demonstrated by a pilot skin cancer screening study conducted in Germany, there are mixed perspectives on the screening program’s success, according to a presenter at the HemOnc Today Melanoma and Cutaneous Malignancies meeting.
Axel Hauschild, MD, professor of dermatology at University Hospital Schleswig-Holstein, Campus Kiel, in Germany, provided an update from his 2013 presentation here and also looked at the success of the skin cancer screening success from the viewpoints of four different groups.
Axel Hauschild
The SCREEN (Skin Cancer Research to provide Evidence of Effectiveness of screening in Northern Germany) study was conducted in the German state of Schleswig-Holstein. The systematic skin cancer screening project that included 360,000 healthy volunteers in a homogenous population. Initially, the screening was for those aged 35 years or older, but the minimum age was reduced to 20 years because of the high incidence of skin cancer among women in the younger age bracket (20 to 35 years).
In the first step of the program, either a general practitioner or dermatologist conducted the screening. If a patient was identified as at risk for or suspicious for melanoma, a dermatologist performed the lesion excision and treatment.
“It is a question of the perspective” when determining how successful the program was, Hauschild said.
Without systemic invitation, 38% of the eligible population underwent skin cancer screening. Of the volunteers, 90% of those who completed patient satisfaction surveys reported overwhelming acceptance of the program. Because of these two reasons, Hauschild said the perspective of the patient was positive, a relative “thumbs up.”
Most insurance companies offered skin cancer screening for volunteers aged 20 years or more; some even earlier, he said. The perspective of the screening from an insurance company also was a “thumbs up,” as the insurance companies were supportive, pleased with the screening and wanted to continue the initiative, Hauschild said.
To determine the physicians’ perspective, Hauschild looked at all factors mentioned earlier (acceptance rate and the number of patients screened), but also at the financial gain. Each screening cost 20 euros and this was “extrabudgetary money,” so the screening was also a financial win for the physician screeners. For that, Hauschild also deemed it a “thumbs up.”
Hauschild also looked at the success of the program from a scientific perspective. He said that of the 360,000 participants, 3,100 skin cancers were detected, and screening was associated with a 52% reduction in mortality.
Although the results were positive, the screening program was a “thumbs down” from the scientific perspective because it was a pilot study in just one state, and because no randomized, controlled clinical trial has been conducted. – by Joan-Marie Stiglich, ELS
For more information:
Hauschild A. Lessons from Germany: The new vanguard of early detection and the role of Melafind. Presented at: HemOnc Today Melanoma and Cutaneous Malignancies; April 11-12, 2014; New York.
Disclosure: Hauschild reports consultant fees and lecture fees from, as well as speakers bureau roles, advisory board roles and contracted research with, Amgen, Bristol-Myers Squibb, Eisai, GlaxoSmithKline, MedImmune, Melasciences, Merck Serono, MSD/Merck & Co., Novartis, OncoSec and Roche Pharmaceuticals.