title: Does skin cancer screening save lives?: an observational study comparing trends in melanoma mortality in regions with and without screening.
abstract: BACKGROUND
  From July 1, 2003 to June 30, 2004, a population-based skin cancer screening project was conducted in Schleswig-Holstein, Germany. In total, 360,288 individuals aged ≥20 years were screened by means of a whole-body examination. In this report, the authors compare trends in melanoma mortality in Schleswig-Holstein with those in all adjacent regions, none of which had population-based skin cancer screening.
  
  
  METHODS
  Trends in melanoma mortality rates for Schleswig-Holstein and the adjacent regions (Denmark and the German federal states of Mecklenburg-Vorpommern, Hamburg, and Lower Saxony) and in Germany excluding Schleswig-Holstein were compared. Log-linear regression was used to assess mortality trends.
  
  
  RESULTS
  In Schleswig-Holstein during the pre skin cancer screening period (1998-1999), the age-standardized melanoma mortality rate (World standard population) was 1.9 per 100,000 for men and 1.4 per 100,000 for women. Melanoma mortality declined by 47% to 1.0 per 100,000 men and by 49% to 0.7 per 100,000 women by 2008/2009. The annual percentage change in the most recent 10-year period (2000-2009) was -7.5% (95% confidence interval, -14.0, -0.5) for men and -7.1% (95% confidence interval, -10.5, -2.9) for women. In each of the 4 adjacent regions and in the rest of Germany, mortality rates were stable, and the decline in Schleswig-Holstein was significantly different from the changes observed in all of the other areas studied.
  
  
  CONCLUSIONS
  The current data represent strong evidence, but not absolute proof, that the skin cancer screening program produced a reduction in melanoma mortality in Schleswig-Holstein.
authors.affiliation: Institute of Clinical Epidemiology, University Hospital Schleswig-Holstein, Campus Luebeck, Luebeck, Germany. alexander.katalinic@uksh.de
authors.forename: Alexander
authors.initials: A
authors.lastname: Katalinic
authors.forename: Annika
authors.initials: A
authors.lastname: Waldmann
authors.forename: Martin A
authors.initials: MA
authors.lastname: Weinstock
authors.forename: Alan C
authors.initials: AC
authors.lastname: Geller
authors.forename: Nora
authors.initials: N
authors.lastname: Eisemann
authors.forename: Ruediger
authors.initials: R
authors.lastname: Greinert
authors.forename: Beate
authors.initials: B
authors.lastname: Volkmer
authors.forename: Eckhard
authors.initials: E
authors.lastname: Breitbart
mesh_terms: D000328:Adult; D055088:Early Detection of Cancer; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008545:Melanoma / Q000401:mortality*; D012878:Skin Neoplasms / Q000401:mortality*; D055815:Young Adult