title: The relation between mortality from malignant melanoma and early detection in the Cancer Research Campaign Mole Watcher Study.
abstract: Between 1987 and 1989 the Cancer Research Campaign funded a health education programme for the early detection of cutaneous malignant melanoma in the general population in 6 health districts of England and 1 health board in Scotland (population of 3 million). The intervention was evaluated by studying its effects on annual and cumulative mortality rates for melanoma. Population-based data on mortality from melanoma were collected in the intervention areas, the health regions covering those areas, and 5 other health regions of England from 1981 to 1996. Deaths from melanoma in cases diagnosed after the start of the intervention were used to study cumulative mortality rates. The annual mortality rates for melanoma, 1981 to 1996, showed no significant difference in their trends between the intervention areas, and other areas of England and Wales. After adjustment for pre-intervention rates, there was also no significant reduction in cumulative mortality from melanoma in the intervention areas compared with the non-intervention areas: rate ratio 1.2 (95% Cl 0.9-1.7) in men, 0.9 (95% Cl 0.7-1.3) in females. The lack of a significant reduction in melanoma mortality associated with the intervention raises questions about this approach to early detection and emphasises the need for new strategies.
authors.affiliation: Cancer Screening Evaluation Unit, Institute of Cancer Research, Section of Epidemiology, D Block, Cotswold Road, Sutton, Surrey SM2 5NG, UK.
authors.forename: J
authors.initials: J
authors.lastname: Melia
authors.forename: S
authors.initials: S
authors.lastname: Moss
authors.forename: D
authors.initials: D
authors.lastname: Coleman
authors.forename: T
authors.initials: T
authors.lastname: Frost
authors.forename: R
authors.initials: R
authors.lastname: Graham-Brown
authors.forename: J A
authors.initials: JA
authors.lastname: Hunter
authors.forename: R A
authors.initials: RA
authors.lastname: Marsden
authors.forename: A
authors.initials: A
authors.lastname: du Vivier
authors.forename: A P
authors.initials: AP
authors.lastname: Warin
authors.forename: J
authors.initials: J
authors.lastname: White
authors.forename: S M
authors.initials: SM
authors.lastname: Whitehead
authors.forename: M A
authors.initials: MA
authors.lastname: Wroughton
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004739:England / Q000453:epidemiology; D005260:Female; D006293:Health Promotion; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000401:mortality* / Q000517:prevention & control; D008875:Middle Aged; D011159:Population Surveillance; D012737:Sex Factors; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000401:mortality* / Q000517:prevention & control