Skin cancer screening in Germany: review after ten years

Abstract

In 2008, anationwide population-based skin cancer screening program was introduced in Germany. Its potential to reduce the skin cancer-related burden of disease is the subject of acontroversial debate. This article gives an overview on the epidemiology of cutaneous melanoma of the skin and nonmelanoma skin cancer, on the history and practice of the current program, and appraises the evidence of screening for skin cancer based on aselective search for literature and data.The incidence of skin cancer has increased markedly throughout the last decades. The available evidence indicates efficacy of screening for skin cancer, but on alow level. Randomized controlled trials are lacking and the available evidence is based largely on the pilot study SCREEN which was conducted in 2003/2004 in Schleswig-Holstein, Germany. Following this pilot study, amarked decline of melanoma mortality was observed. After implementation of nationwide skin cancer screening, amortality reduction has not appeared so far.Acomparison of nationwide skin cancer screening and the SCREEN project suggests alower intensity of the current screening program. Its process and outcome quality requires further investigations. Improved documentation allowing for alinkage between screening procedures conducted by nondermatologists and dermatologists is desirable. Personal invitations could help to reach individuals who currently make little or no use of skin cancer screening but might benefit from it.