title: Monitoring of naevus density at age 6: Is it both feasible and meaningful?
abstract: BACKGROUND
  Instruments for the evaluation of campaigns targeting the reduction of UV exposure in the population, and thus skin cancer risk, are needed.
  
  
  OBJECTIVE
  To examine the "childhood monitoring of naevus density" approach suggested some 10 years ago in a routine setting of mandatory pre-school examinations.
  
  
  METHODS
  Data were collected between 1999 and 2005 in Göttingen, Wolfenbüttel, Northeim, Salzgitter, and Erlangen. Besides basic data, freckling, iris and hair colour, and "Fitzpatrick skin type" as well as counts of melanocytic naevi were documented. Negative binomial regression analysis quantified the association between naevus counts and above factors, and year and site of examination, respectively.
  
  
  RESULTS
  Of 12,809 children examined at five different sites over a period of 6 years, 11,345 were eligible for the analysis. While differences between sites were marked and significant, only a very minute, albeit significant, decrease in risk was found between the reference group (Göttingen 1999/2000) and the last year examined in Göttingen (2005).
  
  
  CONCLUSIONS
  Significant between-site variation in the analysis adjusted for constitutional factors points to problems with standardization; thus, a broad application of this instrument does not seem to be advisable.
authors.affiliation: Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany. Electronic address: wolfgang.uter@imbe.med.uni-erlangen.de.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Uter
authors.affiliation: Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Fießler
authors.affiliation: Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany.
authors.forename: Olaf
authors.initials: O
authors.lastname: Gefeller
authors.affiliation: Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany.
authors.forename: Annette
authors.initials: A
authors.lastname: Pfahlberg
mesh_terms: D002648:Child; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008545:Melanoma / Q000209:etiology / Q000517:prevention & control*; D009506:Nevus / Q000150:complications; D009508:Nevus, Pigmented / Q000150:complications*; D010808:Physical Examination; D012307:Risk Factors; D012867:Skin / Q000528:radiation effects*; D012878:Skin Neoplasms / Q000209:etiology / Q000517:prevention & control*; D014466:Ultraviolet Rays
keywords: Malignant melanoma; Melanocytic nevi; Primary prevention; Public health surveillance; Risk factors