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Arch Dermatol. 2012 Aug;148(8):903-10. doi: 10.1001/archdermatol.2012.893.

Frequency of excisions and yields of malignant skin tumors in a population-based screening intervention of 360,288 whole-body examinations.

Author information

1
Institute of Clinical Epidemiology, University Hospital Schleswig-Holstein, Campus Luebeck, Luebeck, Germany. Annika.Waldmann@uksh.de

Abstract

OBJECTIVE:

To explore the frequency of excisions and yields of histopathologically confirmed skin cancer.

DESIGN:

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

SETTING:

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).

MAIN OUTCOME MEASURES:

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.

PMID:
22911184
DOI:
10.1001/archdermatol.2012.893
[Indexed for MEDLINE]

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