title: The effectiveness of a population-based skin cancer screening program: evidence from Germany.
abstract: In this paper, we analyze how a nationwide population-based skin cancer screening program (SCS) implemented in Germany in 2008 has impacted the number of hospital discharges following malignant skin neoplasm diagnosis and the malignant melanoma mortality rate per 100,000 inhabitants. Our panel data, drawn from the Eurostat database, cover subregions in 22 European countries, measured at the lowest nomenclature of territorial units for statistics (NUTS) level for 2000-2013. Applying fixed effects methods, we find a significantly positive and robust effect of the German SCS on the number of patients diagnosed with malignant skin neoplasm. However, the program does not significantly influence the melanoma mortality rate. This finding conflicts with the decreased melanoma mortality rate found for the pilot SCS program in northern Germany. Our results indicate that Germany's nationwide SCS program is effective in terms of a higher diagnosis rate for malignant skin neoplasms and thus may contribute to an improvement in the early detection of skin cancer.
authors.affiliation: Institute for Health Care & Public Management, University of Hohenheim, Stuttgart, Germany.
authors.forename: Micha
authors.initials: M
authors.lastname: Kaiser
authors.affiliation: Institute for Health Care & Public Management, University of Hohenheim, Stuttgart, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Schiller
authors.affiliation: Institute for Health Care & Public Management, University of Hohenheim, Stuttgart, Germany. christopher.schreckenberger@uni-hohenheim.de.
authors.forename: Christopher
authors.identifier: http://orcid.org/0000-0003-2442-0141
authors.initials: C
authors.lastname: Schreckenberger
mesh_terms: D000328:Adult; D000368:Aged; D055088:Early Detection of Cancer; D005260:Female; D005858:Germany; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening; D008545:Melanoma / Q000175:diagnosis* / Q000191:economics; D008875:Middle Aged; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000191:economics
keywords: Cancer prevention; Fixed effect; Melanoma; Screening; Skin cancer