Evidence for skin cancer screening

In 2008 Germany was the first country to introduce a nationwide population-based skin cancer screening after a pilot project in Schleswig-Holstein had shown promising results. This article gives an overview of the current evidence for the effectiveness of a German skin cancer screening program. The number needed to screen was derived from data of the pilot project. The impact of screening on melanoma incidence and mortality was analyzed based on cancer registry data and on mortality statistics from Schleswig-Holstein and adjacent regions. A malignant tumor of the skin was found in 1 out of 116 screening participants and a melanoma in 1 out of 620. The intensified search for skin cancer resulted in an increase in melanoma incidence during the pilot project and a subsequent decline, as expected. A reduction in melanoma mortality was observed in Schleswig-Holstein but not in any of the adjacent regions. The current evidence suggests that a population-based skin cancer screening is feasible and effective; however, further research is urgently needed: Open questions concern the benefit-harm relationship of the skin cancer screening, interval carcinomas and cost-effectiveness.