Studies show benefits of skin cancer screening, but with very low evidence
Skin cancer screening appears to offer benefits based on large ecological studies, a cohort study, a case-control study and a survey, but the evidence level of these reports is very low.
Investigators searched Medline and Embase for research papers published in English or German between 1 January 2005 and 4 February 2015 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.
Study selection, data extraction and critical appraisal were done by two independent reviewers. The results were described in a narrative synthesis. The systematic review included 15 articles from the 2,066 records identified in databases and 10 records found by manual search.
The incidence of in situ and invasive skin cancer rose with the implementation of skin cancer screening based on evidence gathered. Also, researchers found increasing rates of thin and decreasing rates of thick melanoma.
The incidence of invasive melanoma decreased after cessation of screening.
A German study showed a significant decrease in melanoma mortality, while two other reports observed fewer deaths than expected. There was no study on interval cancers identified.
The systematic review had certain weaknesses, including publication bias and the inherent limitation of the studies included due to their ecological design, according to researchers.
Wernli and colleagues presented in a report that, on a population level, no clear statement could be made regarding the benefit of skin cancer screening for melanoma mortality and all-cause mortality or association with thinner lesions due to limited evidence. [Wernli KJ, et al, AHRQ 2016 Report No. 14-05210-EF-1]