The Experts below are selected from a list of 4611 Experts worldwide ranked by ideXlab platform
Alexander Katalinic - One of the best experts on this subject based on the ideXlab platform.
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Observed and expected mortality in the German Skin Cancer Screening pilot project SCREEN.
Journal of medical screening, 2017Co-Authors: Nora Eisemann, Annika Waldmann, Bernd Holleczek, Alexander KatalinicAbstract:ObjectiveThe main purpose of Skin Cancer Screening is melanoma mortality reduction. Before the implementation of nationwide German Skin Cancer Screening, the pilot project SCREEN was conducted in S...
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Impact of Skin Cancer Screening and secondary prevention campaigns on Skin Cancer incidence and mortality: A systematic review.
Journal of the American Academy of Dermatology, 2016Co-Authors: Alicia Brunssen, Nora Eisemann, Annika Waldmann, Alexander KatalinicAbstract: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.
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Skin Cancer Screening in Germany. Documenting Melanoma Incidence and Mortality From 2008 to 2013.
Deutsches Arzteblatt international, 2015Co-Authors: Alexander Katalinic, Nora Eisemann, Annika WaldmannAbstract:Malignant melanoma (MM), basal cell carcinoma (BCC), and squamous cell carcinoma (SCC) are the three most common forms of Skin Cancer. Combined, they make Skin Cancer the most common Cancer in Germany. The Robert Koch Institute forecast around 20 000 new cases of malignant melanoma for 2014. In addition, 150 000 new cases of basal cell carcinoma and 37 000 of squamous cell carcinoma were expected. This is a total of at least 200 000 new Cancers (1). These figures are for first Skin Cancers; as Skin Cancer often occurs multiple times in a single individual, the number of cases requiring treatment may be substantially higher (2). Early detection of Skin Cancer has been a fixed part of the German early Cancer detection guidelines since 1974. Initially, it simply took the form of a question regarding Skin abnormalities (3). The development of Skin Cancer Screening in Germany began in 1999 in the federal state of Schleswig-Holstein. Following some initial pilot Screening in 2001, a feasibility study of population-wide Skin Cancer Screening began in 2003: from July 2003 to June 2004, two-tier Skin Cancer Screening was made available in Schleswig-Holstein (the SCREEN project) (4). Around 360 000 individuals underwent full-body visual inspection. The almost 1800 physicians who participated in the project underwent a compulsory eight-hour training program. A total of 3103 Skin tumors were documented during Screening, of which 585 were malignant melanomas, 1961 basal cell carcinomas, and 392 squamous cell carcinomas. The Screening resulted in more favorable population-based stage distribution of diagnosed malignant melanomas (5). Between 1999 and 2009 there was an almost 50% decrease in melanoma mortality. Comparison of this trend with adjacent regions showed that a decrease in melanoma mortality was seen only in the region covered by Screening (6). Nationwide Skin Cancer Screening was introduced in Germany in mid-2008. From the age of 35 years onwards, every individual with statutory health insurance is now entitled to full-body visual inspection of the Skin at two-year intervals. When this was introduced, quality evaluation of the process and structure of Screening was to be performed five years later (7). This evaluation was recently published but does not include effectiveness evaluation (8). By now more up-to-date incidence and mortality figures have become available, and these can be used for an initial evaluation of the effectiveness of national Skin Cancer Screening in Germany.
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Development of a Microsimulation of Melanoma Mortality for Evaluating the Effectiveness of Population-Based Skin Cancer Screening
Medical decision making : an international journal of the Society for Medical Decision Making, 2014Co-Authors: Nora Eisemann, Annika Waldmann, Claus Garbe, Alexander KatalinicAbstract:Background. A nationwide Skin Cancer Screening (SCS) was implemented in Germany in 2008. It aims at improving early detection of melanoma in order to reduce melanoma mortality. While the idea of early detection is compelling, demonstrating the effectiveness of melanoma Screening is crucial. Since it is not feasible to conduct epidemiological studies to investigate the impact of factors such as Screening interval or targeted age groups, we developed a microsimulation model that is able to predict melanoma mortality in Germany under several SCS conditions. Methods. Using German Cancer registry data, population data, and other published data on melanoma progression and Screening participation, we developed a stochastic microsimulation model. With this model, 10,000 populations of 100,000 persons and their melanoma-related life histories were simulated separately for women and for men and calibrated to observed melanoma incidence. In a second step, life histories of melanoma were changed by an SCS. Results. C...
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Incidence of melanoma and changes in stage-specific incidence after implementation of Skin Cancer Screening in Schleswig-Holstein
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz, 2013Co-Authors: Nora Eisemann, Annika Waldmann, Alexander KatalinicAbstract:A pilot project in Skin Cancer Screening (SCREEN) was conducted in Schleswig-Holstein from July 2003 to June 2004. Although the impact of this Screening on the stage-specific incidence of melanoma is of great importance for Screening evaluation, it remains unknown. In theory, an effective Skin Cancer Screening program should result in a medium-term incidence decrease of melanomas with a prognostically unfavorable stage. This is studied on a population-based level by using Cancer registry data. Based on data from the Cancer Registry of Schleswig-Holstein for 1999-2009, stage-specific (T-category of the TNM-classification system) age-standardized incidence rates were calculated. After implementation of the SCREEN project, the incidence of prognostically favorable melanomas (in situ and T1) was higher than before, while the incidence of advanced melanomas (T2, T3, and for women also T4) decreased considerably. The classification of tumor stages changed during the project period, which may have contributed to an artificial decrease of the stages with a poor prognosis. Nevertheless, the results are in agreement with the observed decrease of melanoma mortality in the Screening region.
Alan C. Geller - One of the best experts on this subject based on the ideXlab platform.
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A Large Skin Cancer Screening Quality Initiative: Description and First-Year Outcomes.
JAMA oncology, 2017Co-Authors: Laura K. Ferris, Alan C. Geller, Martin A. Weinstock, Melissa Saul, Yan Lin, Fei Ding, Jian-min Yuan, Erica Bromberg Neuren, Spandana Maddukuri, Francis X. SolanoAbstract:Importance The lack of prospective randomized clinical trials demonstrating that full-body Skin examination (FBSE) reduces melanoma morbidity or mortality has prompted an “I” rating from the United States Preventive Services Task Force for population-based Skin Cancer Screening. More data on these Screening programs are needed. Objectives To describe a Skin Cancer Screening quality initiative in a large health care system and to determine if the intervention was associated with Screening of a demographically higher-risk population than previous Screening programs and if melanoma incidence and thickness differed in screened vs unscreened patients. Design, Setting, and Participants This observational evaluation of a prospectively implemented quality initiative was conducted in a large health care system in western Pennsylvania (University of Pittsburgh Medical Center, UPMC) among adults seen in an office visit by a UPMC-employed primary care physician (PCP) in 2014. Interventions Implementation of a campaign promoting annual Skin Cancer Screening by FBSE, including training of PCPs, promotion of the initiative to physicians and patients, and modification of the electronic health record (EHR) to include FBSE as a recommended preventive service for patients 35 years or older. Main Outcomes and Measures Characteristics of screened and unscreened patients and melanomas detected among them. Results Of 333 735 adult patients seen in an office visit by PCPs in 2014, 53 196 patients (15.9% of the screen-eligible population) received an FBSE, and 280 539 did not. Screened patients were slightly older (median age, 60 vs 57 years; P P = .49) from the unscreened population. Fifty melanomas were diagnosed in screened patients and 104 melanomas were diagnosed in unscreened patients. Screened patients were more likely than unscreened patients to be diagnosed with melanoma (adjusted risk ratio [RR], 2.4; 95% CI, 1.7-3.4; P P P = .52). Conclusions and Relevance Large-scale Screening for melanoma within a United States health care system is feasible and can result in increased detection of thinner melanomas. This intervention also resulted in Screening of a higher proportion of men and an older patient population than previous Screening interventions in which younger individuals and women predominated.
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Preliminary outcomes of a primary care-based Skin Cancer Screening program.
Journal of Clinical Oncology, 2016Co-Authors: Laura K. Ferris, Alan C. Geller, Martin A. Weinstock, Melissa Saul, Yan Lin, Erica Bromberg Neuren, Francis X. Solano, John M. KirkwoodAbstract:1508Background: Screening for melanoma has the potential to save lives through early detection. However, few studies of organized Screening programs have been reported in the United States. Methods: Primary care providers (PCPs) who are part of UPMC, a large health care system in western Pennsylvania, were offered online training in Skin Cancer Screening (using the validated INFORMED module) and asked to provide an annual Skin examination to patients age 35 years and older who presented for routine care. Demographics of screened patients, Screening rate by PCP completion of training, and depth of melanomas diagnosed in screened vs. unscreened patients for the first 12 months of this initiative are presented. Results: In 2014, 333,788 screen-eligible patients were seen at UPMC and 51,772 (15.5%) were screened for Skin Cancer; the remaining patients made up the unscreened cohort. Patients seen by a PCP who completed the online training were more likely to be screened (24.7% of eligible patients vs. 12.6% wi...
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Non-melanoma Skin Cancer Incidence and Impact of Skin Cancer Screening on Incidence
The Journal of investigative dermatology, 2013Co-Authors: Nora Eisemann, Annika Waldmann, Eckhard W. Breitbart, Ruediger Greinert, Beate Volkmer, Alan C. Geller, Martin A. Weinstock, Alexander KatalinicAbstract:Non-melanoma Skin Cancer (NMSC) is the most common malignancy, whose public health significance is often unrecognized. This analysis has two objectives: first, to provide up-to-date incidence estimates by sex, age group, histological type, and body site; and second, to study the impact of Skin Cancer Screening. The impact of Screening on NMSC incidence in Schleswig-Holstein, Germany, is analyzed by comparing four time periods of different Screening settings (no Screening (1998–2000), pilot project (Skin Cancer Research to Provide Evidence for Effectiveness of Screening in Northern Germany, SCREEN, 2003–2004), after SCREEN (2004–2008), and nation-wide Skin Cancer Screening (2008–2010)) to a reference region (Saarland, Germany). Age-standardized (Europe) NMSC incidence was 119/100,000 for women and 145/100,000 for men in the most recent Screening period in Schleswig-Holstein (2008–2010). During implementation of SCREEN (2003–2004), incidence increased from 81.5/100,000 to 111.5/100,000 (1998–2000) by 47% for women and 34% for men. All age groups in women were affected by the increase, but increases for men were mostly limited to the older age groups. Incidence in Saarland first increased slowly, but increased steeply with the introduction of the nation-wide Skin Cancer Screening in 2008 (+47% for women and +40% for men, reference 2004–2008). Observed changes are most likely attributed to Screening activities.
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does Skin Cancer Screening save lives an observational study comparing trends in melanoma mortality in regions with and without Screening
Cancer, 2012Co-Authors: Alexander Katalinic, Nora Eisemann, Annika Waldmann, Beate Volkmer, Alan C. Geller, Martin A. Weinstock, R Greinert, Eckhard W. BreitbartAbstract: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.
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Does Skin Cancer Screening save lives?: an observational study comparing trends in melanoma mortality in regions with and without Screening.
Cancer, 2012Co-Authors: Alexander Katalinic, Nora Eisemann, Annika Waldmann, Ruediger Greinert, Beate Volkmer, Alan C. Geller, Martin A. Weinstock, Eckhard W. BreitbartAbstract: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. Cancer 2012. © 2012 American Cancer Society.
Martin A. Weinstock - One of the best experts on this subject based on the ideXlab platform.
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A Large Skin Cancer Screening Quality Initiative: Description and First-Year Outcomes.
JAMA oncology, 2017Co-Authors: Laura K. Ferris, Alan C. Geller, Martin A. Weinstock, Melissa Saul, Yan Lin, Fei Ding, Jian-min Yuan, Erica Bromberg Neuren, Spandana Maddukuri, Francis X. SolanoAbstract:Importance The lack of prospective randomized clinical trials demonstrating that full-body Skin examination (FBSE) reduces melanoma morbidity or mortality has prompted an “I” rating from the United States Preventive Services Task Force for population-based Skin Cancer Screening. More data on these Screening programs are needed. Objectives To describe a Skin Cancer Screening quality initiative in a large health care system and to determine if the intervention was associated with Screening of a demographically higher-risk population than previous Screening programs and if melanoma incidence and thickness differed in screened vs unscreened patients. Design, Setting, and Participants This observational evaluation of a prospectively implemented quality initiative was conducted in a large health care system in western Pennsylvania (University of Pittsburgh Medical Center, UPMC) among adults seen in an office visit by a UPMC-employed primary care physician (PCP) in 2014. Interventions Implementation of a campaign promoting annual Skin Cancer Screening by FBSE, including training of PCPs, promotion of the initiative to physicians and patients, and modification of the electronic health record (EHR) to include FBSE as a recommended preventive service for patients 35 years or older. Main Outcomes and Measures Characteristics of screened and unscreened patients and melanomas detected among them. Results Of 333 735 adult patients seen in an office visit by PCPs in 2014, 53 196 patients (15.9% of the screen-eligible population) received an FBSE, and 280 539 did not. Screened patients were slightly older (median age, 60 vs 57 years; P P = .49) from the unscreened population. Fifty melanomas were diagnosed in screened patients and 104 melanomas were diagnosed in unscreened patients. Screened patients were more likely than unscreened patients to be diagnosed with melanoma (adjusted risk ratio [RR], 2.4; 95% CI, 1.7-3.4; P P P = .52). Conclusions and Relevance Large-scale Screening for melanoma within a United States health care system is feasible and can result in increased detection of thinner melanomas. This intervention also resulted in Screening of a higher proportion of men and an older patient population than previous Screening interventions in which younger individuals and women predominated.
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Preliminary outcomes of a primary care-based Skin Cancer Screening program.
Journal of Clinical Oncology, 2016Co-Authors: Laura K. Ferris, Alan C. Geller, Martin A. Weinstock, Melissa Saul, Yan Lin, Erica Bromberg Neuren, Francis X. Solano, John M. KirkwoodAbstract:1508Background: Screening for melanoma has the potential to save lives through early detection. However, few studies of organized Screening programs have been reported in the United States. Methods: Primary care providers (PCPs) who are part of UPMC, a large health care system in western Pennsylvania, were offered online training in Skin Cancer Screening (using the validated INFORMED module) and asked to provide an annual Skin examination to patients age 35 years and older who presented for routine care. Demographics of screened patients, Screening rate by PCP completion of training, and depth of melanomas diagnosed in screened vs. unscreened patients for the first 12 months of this initiative are presented. Results: In 2014, 333,788 screen-eligible patients were seen at UPMC and 51,772 (15.5%) were screened for Skin Cancer; the remaining patients made up the unscreened cohort. Patients seen by a PCP who completed the online training were more likely to be screened (24.7% of eligible patients vs. 12.6% wi...
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Non-melanoma Skin Cancer Incidence and Impact of Skin Cancer Screening on Incidence
The Journal of investigative dermatology, 2013Co-Authors: Nora Eisemann, Annika Waldmann, Eckhard W. Breitbart, Ruediger Greinert, Beate Volkmer, Alan C. Geller, Martin A. Weinstock, Alexander KatalinicAbstract:Non-melanoma Skin Cancer (NMSC) is the most common malignancy, whose public health significance is often unrecognized. This analysis has two objectives: first, to provide up-to-date incidence estimates by sex, age group, histological type, and body site; and second, to study the impact of Skin Cancer Screening. The impact of Screening on NMSC incidence in Schleswig-Holstein, Germany, is analyzed by comparing four time periods of different Screening settings (no Screening (1998–2000), pilot project (Skin Cancer Research to Provide Evidence for Effectiveness of Screening in Northern Germany, SCREEN, 2003–2004), after SCREEN (2004–2008), and nation-wide Skin Cancer Screening (2008–2010)) to a reference region (Saarland, Germany). Age-standardized (Europe) NMSC incidence was 119/100,000 for women and 145/100,000 for men in the most recent Screening period in Schleswig-Holstein (2008–2010). During implementation of SCREEN (2003–2004), incidence increased from 81.5/100,000 to 111.5/100,000 (1998–2000) by 47% for women and 34% for men. All age groups in women were affected by the increase, but increases for men were mostly limited to the older age groups. Incidence in Saarland first increased slowly, but increased steeply with the introduction of the nation-wide Skin Cancer Screening in 2008 (+47% for women and +40% for men, reference 2004–2008). Observed changes are most likely attributed to Screening activities.
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does Skin Cancer Screening save lives an observational study comparing trends in melanoma mortality in regions with and without Screening
Cancer, 2012Co-Authors: Alexander Katalinic, Nora Eisemann, Annika Waldmann, Beate Volkmer, Alan C. Geller, Martin A. Weinstock, R Greinert, Eckhard W. BreitbartAbstract: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.
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Does Skin Cancer Screening save lives?: an observational study comparing trends in melanoma mortality in regions with and without Screening.
Cancer, 2012Co-Authors: Alexander Katalinic, Nora Eisemann, Annika Waldmann, Ruediger Greinert, Beate Volkmer, Alan C. Geller, Martin A. Weinstock, Eckhard W. BreitbartAbstract: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. Cancer 2012. © 2012 American Cancer Society.
Annika Waldmann - One of the best experts on this subject based on the ideXlab platform.
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Observed and expected mortality in the German Skin Cancer Screening pilot project SCREEN.
Journal of medical screening, 2017Co-Authors: Nora Eisemann, Annika Waldmann, Bernd Holleczek, Alexander KatalinicAbstract:ObjectiveThe main purpose of Skin Cancer Screening is melanoma mortality reduction. Before the implementation of nationwide German Skin Cancer Screening, the pilot project SCREEN was conducted in S...
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Impact of Skin Cancer Screening and secondary prevention campaigns on Skin Cancer incidence and mortality: A systematic review.
Journal of the American Academy of Dermatology, 2016Co-Authors: Alicia Brunssen, Nora Eisemann, Annika Waldmann, Alexander KatalinicAbstract: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.
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Skin Cancer Screening in Germany. Documenting Melanoma Incidence and Mortality From 2008 to 2013.
Deutsches Arzteblatt international, 2015Co-Authors: Alexander Katalinic, Nora Eisemann, Annika WaldmannAbstract:Malignant melanoma (MM), basal cell carcinoma (BCC), and squamous cell carcinoma (SCC) are the three most common forms of Skin Cancer. Combined, they make Skin Cancer the most common Cancer in Germany. The Robert Koch Institute forecast around 20 000 new cases of malignant melanoma for 2014. In addition, 150 000 new cases of basal cell carcinoma and 37 000 of squamous cell carcinoma were expected. This is a total of at least 200 000 new Cancers (1). These figures are for first Skin Cancers; as Skin Cancer often occurs multiple times in a single individual, the number of cases requiring treatment may be substantially higher (2). Early detection of Skin Cancer has been a fixed part of the German early Cancer detection guidelines since 1974. Initially, it simply took the form of a question regarding Skin abnormalities (3). The development of Skin Cancer Screening in Germany began in 1999 in the federal state of Schleswig-Holstein. Following some initial pilot Screening in 2001, a feasibility study of population-wide Skin Cancer Screening began in 2003: from July 2003 to June 2004, two-tier Skin Cancer Screening was made available in Schleswig-Holstein (the SCREEN project) (4). Around 360 000 individuals underwent full-body visual inspection. The almost 1800 physicians who participated in the project underwent a compulsory eight-hour training program. A total of 3103 Skin tumors were documented during Screening, of which 585 were malignant melanomas, 1961 basal cell carcinomas, and 392 squamous cell carcinomas. The Screening resulted in more favorable population-based stage distribution of diagnosed malignant melanomas (5). Between 1999 and 2009 there was an almost 50% decrease in melanoma mortality. Comparison of this trend with adjacent regions showed that a decrease in melanoma mortality was seen only in the region covered by Screening (6). Nationwide Skin Cancer Screening was introduced in Germany in mid-2008. From the age of 35 years onwards, every individual with statutory health insurance is now entitled to full-body visual inspection of the Skin at two-year intervals. When this was introduced, quality evaluation of the process and structure of Screening was to be performed five years later (7). This evaluation was recently published but does not include effectiveness evaluation (8). By now more up-to-date incidence and mortality figures have become available, and these can be used for an initial evaluation of the effectiveness of national Skin Cancer Screening in Germany.
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Development of a Microsimulation of Melanoma Mortality for Evaluating the Effectiveness of Population-Based Skin Cancer Screening
Medical decision making : an international journal of the Society for Medical Decision Making, 2014Co-Authors: Nora Eisemann, Annika Waldmann, Claus Garbe, Alexander KatalinicAbstract:Background. A nationwide Skin Cancer Screening (SCS) was implemented in Germany in 2008. It aims at improving early detection of melanoma in order to reduce melanoma mortality. While the idea of early detection is compelling, demonstrating the effectiveness of melanoma Screening is crucial. Since it is not feasible to conduct epidemiological studies to investigate the impact of factors such as Screening interval or targeted age groups, we developed a microsimulation model that is able to predict melanoma mortality in Germany under several SCS conditions. Methods. Using German Cancer registry data, population data, and other published data on melanoma progression and Screening participation, we developed a stochastic microsimulation model. With this model, 10,000 populations of 100,000 persons and their melanoma-related life histories were simulated separately for women and for men and calibrated to observed melanoma incidence. In a second step, life histories of melanoma were changed by an SCS. Results. C...
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Incidence of melanoma and changes in stage-specific incidence after implementation of Skin Cancer Screening in Schleswig-Holstein
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz, 2013Co-Authors: Nora Eisemann, Annika Waldmann, Alexander KatalinicAbstract:A pilot project in Skin Cancer Screening (SCREEN) was conducted in Schleswig-Holstein from July 2003 to June 2004. Although the impact of this Screening on the stage-specific incidence of melanoma is of great importance for Screening evaluation, it remains unknown. In theory, an effective Skin Cancer Screening program should result in a medium-term incidence decrease of melanomas with a prognostically unfavorable stage. This is studied on a population-based level by using Cancer registry data. Based on data from the Cancer Registry of Schleswig-Holstein for 1999-2009, stage-specific (T-category of the TNM-classification system) age-standardized incidence rates were calculated. After implementation of the SCREEN project, the incidence of prognostically favorable melanomas (in situ and T1) was higher than before, while the incidence of advanced melanomas (T2, T3, and for women also T4) decreased considerably. The classification of tumor stages changed during the project period, which may have contributed to an artificial decrease of the stages with a poor prognosis. Nevertheless, the results are in agreement with the observed decrease of melanoma mortality in the Screening region.
Nora Eisemann - One of the best experts on this subject based on the ideXlab platform.
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Observed and expected mortality in the German Skin Cancer Screening pilot project SCREEN.
Journal of medical screening, 2017Co-Authors: Nora Eisemann, Annika Waldmann, Bernd Holleczek, Alexander KatalinicAbstract:ObjectiveThe main purpose of Skin Cancer Screening is melanoma mortality reduction. Before the implementation of nationwide German Skin Cancer Screening, the pilot project SCREEN was conducted in S...
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Impact of Skin Cancer Screening and secondary prevention campaigns on Skin Cancer incidence and mortality: A systematic review.
Journal of the American Academy of Dermatology, 2016Co-Authors: Alicia Brunssen, Nora Eisemann, Annika Waldmann, Alexander KatalinicAbstract: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.
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Skin Cancer Screening in Germany. Documenting Melanoma Incidence and Mortality From 2008 to 2013.
Deutsches Arzteblatt international, 2015Co-Authors: Alexander Katalinic, Nora Eisemann, Annika WaldmannAbstract:Malignant melanoma (MM), basal cell carcinoma (BCC), and squamous cell carcinoma (SCC) are the three most common forms of Skin Cancer. Combined, they make Skin Cancer the most common Cancer in Germany. The Robert Koch Institute forecast around 20 000 new cases of malignant melanoma for 2014. In addition, 150 000 new cases of basal cell carcinoma and 37 000 of squamous cell carcinoma were expected. This is a total of at least 200 000 new Cancers (1). These figures are for first Skin Cancers; as Skin Cancer often occurs multiple times in a single individual, the number of cases requiring treatment may be substantially higher (2). Early detection of Skin Cancer has been a fixed part of the German early Cancer detection guidelines since 1974. Initially, it simply took the form of a question regarding Skin abnormalities (3). The development of Skin Cancer Screening in Germany began in 1999 in the federal state of Schleswig-Holstein. Following some initial pilot Screening in 2001, a feasibility study of population-wide Skin Cancer Screening began in 2003: from July 2003 to June 2004, two-tier Skin Cancer Screening was made available in Schleswig-Holstein (the SCREEN project) (4). Around 360 000 individuals underwent full-body visual inspection. The almost 1800 physicians who participated in the project underwent a compulsory eight-hour training program. A total of 3103 Skin tumors were documented during Screening, of which 585 were malignant melanomas, 1961 basal cell carcinomas, and 392 squamous cell carcinomas. The Screening resulted in more favorable population-based stage distribution of diagnosed malignant melanomas (5). Between 1999 and 2009 there was an almost 50% decrease in melanoma mortality. Comparison of this trend with adjacent regions showed that a decrease in melanoma mortality was seen only in the region covered by Screening (6). Nationwide Skin Cancer Screening was introduced in Germany in mid-2008. From the age of 35 years onwards, every individual with statutory health insurance is now entitled to full-body visual inspection of the Skin at two-year intervals. When this was introduced, quality evaluation of the process and structure of Screening was to be performed five years later (7). This evaluation was recently published but does not include effectiveness evaluation (8). By now more up-to-date incidence and mortality figures have become available, and these can be used for an initial evaluation of the effectiveness of national Skin Cancer Screening in Germany.
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Development of a Microsimulation of Melanoma Mortality for Evaluating the Effectiveness of Population-Based Skin Cancer Screening
Medical decision making : an international journal of the Society for Medical Decision Making, 2014Co-Authors: Nora Eisemann, Annika Waldmann, Claus Garbe, Alexander KatalinicAbstract:Background. A nationwide Skin Cancer Screening (SCS) was implemented in Germany in 2008. It aims at improving early detection of melanoma in order to reduce melanoma mortality. While the idea of early detection is compelling, demonstrating the effectiveness of melanoma Screening is crucial. Since it is not feasible to conduct epidemiological studies to investigate the impact of factors such as Screening interval or targeted age groups, we developed a microsimulation model that is able to predict melanoma mortality in Germany under several SCS conditions. Methods. Using German Cancer registry data, population data, and other published data on melanoma progression and Screening participation, we developed a stochastic microsimulation model. With this model, 10,000 populations of 100,000 persons and their melanoma-related life histories were simulated separately for women and for men and calibrated to observed melanoma incidence. In a second step, life histories of melanoma were changed by an SCS. Results. C...
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Incidence of melanoma and changes in stage-specific incidence after implementation of Skin Cancer Screening in Schleswig-Holstein
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz, 2013Co-Authors: Nora Eisemann, Annika Waldmann, Alexander KatalinicAbstract:A pilot project in Skin Cancer Screening (SCREEN) was conducted in Schleswig-Holstein from July 2003 to June 2004. Although the impact of this Screening on the stage-specific incidence of melanoma is of great importance for Screening evaluation, it remains unknown. In theory, an effective Skin Cancer Screening program should result in a medium-term incidence decrease of melanomas with a prognostically unfavorable stage. This is studied on a population-based level by using Cancer registry data. Based on data from the Cancer Registry of Schleswig-Holstein for 1999-2009, stage-specific (T-category of the TNM-classification system) age-standardized incidence rates were calculated. After implementation of the SCREEN project, the incidence of prognostically favorable melanomas (in situ and T1) was higher than before, while the incidence of advanced melanomas (T2, T3, and for women also T4) decreased considerably. The classification of tumor stages changed during the project period, which may have contributed to an artificial decrease of the stages with a poor prognosis. Nevertheless, the results are in agreement with the observed decrease of melanoma mortality in the Screening region.