Does skin cancer screening save lives?: an observational study comparing trends in melanoma mortality in regions with and without screening

Cancer. 2012 Nov 1;118(21):5395-402. doi: 10.1002/cncr.27566. Epub 2012 Apr 19.


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.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Early Detection of Cancer*
  • Female
  • Germany
  • Humans
  • Male
  • Melanoma / mortality*
  • Skin Neoplasms / mortality*
  • Young Adult