Do patients benefit from participating in the German skin cancer screening programme?

Linked Article: Datzmann et al. Br J Dermatol 2022; 186:69–77.

The German skin cancer screening programme began in 2008 with the aim of reducing deaths from skin cancer by detecting skin cancers early, when they are more easily treated. More than 10 years after its launch, the benefits and risks of the programme are still unclear.

In this study, we compared deaths in patients with newly diagnosed melanoma who participated in the German skin cancer screening programme between the years of 2010 and 2016 with deaths in patients who did not. Melanoma is a serious form of skin cancer that occurs mostly in older people. In Europe, about 20 new cases of melanoma per 100,000 people are diagnosed per year, with numbers rising over recent years.

We used health insurance data from over 1,400,000 people. We identified people with newly diagnosed melanoma and calculated the survival times for those who did and did not participate in the screening programme.

Patients who had participated in screening had lower death rates than patients who had not undergone screening. To make the comparison as fair as possible, we took account of differences in age, sex, education, other health conditions, voluntary vaccinations and health check-ups in our analysis, as well as starting treatment within 30 days of their initial melanoma diagnosis. After controlling for these aspects, screening participants still showed a survival advantage. People in the screening programme were initially diagnosed with less severe melanoma and therefore had fewer radical treatments than the other patients. However, we cannot exclude the possibility of bias in the results, for example, because healthier people may have participated in the screening programme as they may be more active and health conscious. Further data on the effectiveness of the programme are needed, however, if our results are confirmed, this would suggest that the German skin cancer screening programme should be continued.