Original article
Impact of skin cancer screening and secondary prevention campaigns on skin cancer incidence and mortality: A systematic review

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Background

Benefits of skin cancer screening remain controversial.

Objective

We sought to update evidence on the impact of skin cancer screening and secondary prevention campaigns on skin cancer incidence, mortality, stage-specific incidence, and interval cancers after negative screening.

Methods

We searched MEDLINE and EMBASE for studies published in English or German between January 1, 2005, and February 4, 2015. Two reviewers independently performed study selection, data extraction, and critical appraisal. Results were described in a narrative synthesis.

Results

Of 2066 records identified in databases and 10 records found by manual search, we included 15 articles. Overall, evidence suggests that with implementation of skin cancer screening, incidence of in situ and invasive skin cancer increased; increasing rates of thin and decreasing rates of thick melanoma were observed. After cessation of screening, invasive melanoma incidence decreased. A significant melanoma mortality reduction was shown in a German study; 2 other studies observed fewer deaths than expected. No study on interval cancers was identified.

Limitations

Publication bias cannot be ruled out. Most studies are limited because of their ecological design.

Conclusion

Large ecological studies, a cohort study, a case-control study, and a survey indicate benefits of skin cancer screening, but the evidence level is very low.

Section snippets

Methods

We conducted a systematic review based on a study protocol that was registered in PROSPERO, the international prospective register of systematic reviews (http://www.crd.york.ac.uk/PROSPERO/; registration number: CRD42014013400).

Results

The systematic literature search yielded 1787 records in MEDLINE, 279 additional records in EMBASE, and 10 records from reference lists. After 1860 records were excluded in the title and abstract screening, we assessed 204 full-text articles for eligibility and included 15 articles.16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30 The study selection process is shown in Fig 1. Our interrater reliability was good (Cohen's kappa 0.64).

Discussion

This review aims to update the evidence on the impact of skin cancer screening or secondary prevention campaigns on skin cancer incidence, mortality, stage-specific incidence, or interval cancers.

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  • Cited by (0)

    Funding sources: None.

    Disclosure: Drs Waldmann, Eisemann, and Katalinic are authors of several of the included publications. Ms Brunssen has no conflicts of interest to declare.

    Supplemental Table I, Supplemental Table II, Supplemental Table III, Supplemental Table IV, Supplemental Table V, Supplemental Table VI are available at http://www.jaad.org.

    PROSPERO registration number: CRD42014013400.

    Presented as a poster at the annual conference of the German Network for Evidence-based Medicine (DNEbM) in Berlin, Germany, on March 13, 2015; an oral presentation at the annual conference of the German Society for Epidemiology in Potsdam, Germany, on October 1, 2015; and an oral presentation at the annual conference of DNEbM in Cologne, Germany, on March 4, 2016.

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