Largest Screening Study Ever Provides Powerful Evidence
The results of the largest population based study of skin cancer screening in history show that regular total body skin exams by physicians can cut melanoma deaths by more than 50 percent. In the SCREEN (Skin Cancer Research to Provide Evidence for Effectiveness of Screening in Northern Germany) study, published in the Journal of the American Academy of Dermatology (JAAD), an unprecedented 360,288 residents of the German state of Schleswig-Holstein ages 20 and older received total-body skin exams from participating physicians, all of whom completed an eight-hour training course prior to the program.
Study subjects chose to be screened by either a dermatologist or a non-dermatologist physician; the latter referred patients with suspicious lesions or high risk factors for skin cancer to a dermatologist. Patients found to have suspicious lesions had skin samples (biopsies) taken from the affected area and examined for evidence of cancer.
More Melanomas Found, but Deaths Go Down
In the yearlong 2003 investigation, 816 melanomas were identified, which is about 200 more melanomas than were found in each of the two preceding years. The authors noted that screenings typically lead to identification of greater numbers of skin cancers, many of which are found at an earlier, more treatable stage than they would have reached without the screening. The results bore this out: in the years following SCREEN, very likely because tumors were thinner when found (as a general rule, the thinner the lesion, the easier to treat), the melanoma death rate was cut in half. Melanoma killed 43 men and 45 women between 1999 and 2002, but just 23 men and 21 women between 2006 and 2008.
The results were so impressive that in 2008, Germany began a national skin cancer screening program, offering people aged 35 or older a total-body skin exam every two years. The authors suggested that such large-scale screening programs are feasible and advisable around the world, and have “the potential to reduce skin cancer burden, including mortality” – which indeed has been the case in Germany.
Because early detection is the key to successful treatment, The Skin Cancer Foundation recommends that everyone obtain a yearly head-to-toe skin exam from a doctor. The Foundation also advises you to examine your own skin head-to-toe once a month; if you find a new or suspicious lesion, see a physician immediately.