Frequency of excisions and yields of malignant skin tumors in a population-based screening intervention of 360 288 whole-body examinations
Waldmann, Annika, Nolte, Sandra, Geller, Alan C., Katalinic, Alexander, Weinstock, Martin A., Volkmer, Beate, Greinert, Ruediger and Breitbar, Eckhard W. 2012, Frequency of excisions and yields of malignant skin tumors in a population-based screening intervention of 360 288 whole-body examinations, JAMA dermatology, vol. 148, no. 8, pp. 903-910, doi: 10.1001/archdermatol.2012.893.
Objective To explore the frequency of excisions and yields of histopathologically confirmed skin cancer.
Design A population-based skin cancer screening intervention (the SCREEN project) in the German state of Schleswig-Holstein (July 1, 2003, to June 30, 2004).
Setting Physician offices. Participants could choose between nondermatologist physicians and dermatologists for their initial whole-body skin examination. All screening physicians received a mandatory 8-hour training course.
Participants Inhabitants of Schleswig-Holstein 20 years or older with statutory health insurance (N = 360 288). Main Outcome Measures Frequency of excisions and yields of malignant skin tumors (malignant melanomas [MMs], basal cell carcinomas [BCCs], and squamous cell carcinomas [SCCs]), stratified by sex and age.
Results Overall, 15 983 excisions were performed (1 of 23 screenees). A total of 3103 malignant skin tumors were diagnosed in 2911 persons: 585 MMs, 1961 BCCs, 392 SCCs, and 165 other malignant skin tumors. Overall, 116 persons (3103 of 360 288) had to be screened to find 1 malignant tumor, with 1 of 620 for MM, 1 of 184 for BCC, and 1 of 920 for SCC. Twenty excisions were performed to find 1 melanoma in men 65 years and older, but more than 50 excisions were required to find 1 melanoma in men aged between 20 and 49 years.
Conclusions The results of SCREEN suggest a high yield of malignant skin tumors in a large-scale population-based screening project. We found that a high number of excisions was performed in the youngest screenees with an associated low yield, suggesting a need in screener training to emphasize a more conservative attitude toward excisions in young screenees.
JAMA Dermatology formerly Archives of Dermatology
Field of Research
119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective
970111 Expanding Knowledge in the Medical and Health Sciences
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