Frequency of excisions and yields of malignant skin tumors in a population-based screening intervention of 360,288 whole-body examinations.
OBJECTIVE
To explore the frequency of excisions and yields of histopathologically confirmed skin cancer.


METHODS
A population-based skin cancer screening intervention (the SCREEN project) in the German state of Schleswig-Holstein (July 1, 2003, to June 30, 2004).


METHODS
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).


METHODS
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.
Institute of Clinical Epidemiology, University Hospital Schleswig-Holstein, Campus Luebeck, Luebeck, Germany. Annika.Waldmann@uksh.de
Annika
A
Waldmann
Sandra
S
Nolte
Alan C
AC
Geller
Alexander
A
Katalinic
Martin A
MA
Weinstock
Beate
B
Volkmer
Ruediger
R
Greinert
Eckhard W
EW
Breitbart
D000328:Adult; D000368:Aged; D002280:Basal Cell Carcinoma / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008545:Melanoma / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D008875:Middle Aged; D012878:Skin Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D055815:Young Adult