Skin Cancer

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Alexander Katalinic - One of the best experts on this subject based on the ideXlab platform.

  • 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, 2016
    Co-Authors: Alicia Brunssen, Nora Eisemann, Annika Waldmann, Alexander Katalinic
    Abstract:

    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.

  • Non-melanoma Skin Cancer Incidence and Impact of Skin Cancer Screening on Incidence
    The Journal of investigative dermatology, 2013
    Co-Authors: Nora Eisemann, Annika Waldmann, Eckhard W. Breitbart, Ruediger Greinert, Beate Volkmer, Alan C. Geller, Martin A. Weinstock, Alexander Katalinic
    Abstract:

    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.

  • Systematic Skin Cancer screening in Northern Germany
    Journal of the American Academy of Dermatology, 2011
    Co-Authors: Eckhard W. Breitbart, Annika Waldmann, Sandra Nolte, Marcus Capellaro, Ruediger Greinert, Beate Volkmer, Alexander Katalinic
    Abstract:

    Background The incidence of Skin Cancer is increasing worldwide. For decades, opportunistic melanoma screening has been carried out to respond to this burden. However, despite potential positive effects such as reduced morbidity and mortality, there is still a lack of evidence for feasibility and effectiveness of organized Skin Cancer screening. Objective The main aim of the project was to evaluate the feasibility of systematic Skin Cancer screening. Methods In 2003, the Association of Dermatological Prevention was contracted to implement the population-based SCREEN project (Skin Cancer Research to Provide Evidence for Effectiveness of Screening in Northern Germany) in the German state of Schleswig-Holstein. A two-step program addressing malignant melanoma and nonmelanocytic Skin Cancer was implemented. Citizens (aged ≥20 years) with statutory health insurance were eligible for a standardized whole-body examination during the 12-month study period. Cancer registry and mortality data were used to assess first effects. Results Of 1.88 million eligible citizens, 360,288 participated in SCREEN. The overall population-based participation rate was 19%. A total of 3103 malignant Skin tumors were found. On the population level, invasive melanoma incidence increased by 34% during SCREEN. Five years after SCREEN a substantial decrease in melanoma mortality was seen (men: observed 0.79/100,000 and expected 2.00/100,000; women: observed 0.66/100,000 and expected 1.30/100,000). Limitations Because of political reasons (resistance as well as lack of support from major German health care stakeholders), it was not possible to conduct a randomized controlled trial. Conclusions The project showed that large-scale systematic Skin Cancer screening is feasible and has the potential to reduce Skin Cancer burden, including mortality. Based on the results of SCREEN, a national statutory Skin Cancer early detection program was implemented in Germany in 2008.

Eckhard W. Breitbart - One of the best experts on this subject based on the ideXlab platform.

  • Non-melanoma Skin Cancer Incidence and Impact of Skin Cancer Screening on Incidence
    The Journal of investigative dermatology, 2013
    Co-Authors: Nora Eisemann, Annika Waldmann, Eckhard W. Breitbart, Ruediger Greinert, Beate Volkmer, Alan C. Geller, Martin A. Weinstock, Alexander Katalinic
    Abstract:

    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.

  • Effectiveness of Skin Cancer screening programmes.
    British Journal of Dermatology, 2012
    Co-Authors: K. Choudhury, Beate Volkmer, Ruediger Greinert, Enno Christophers, Eckhard W. Breitbart
    Abstract:

    Summary Skin Cancer, nonmelanoma Skin Cancer (NMSC) and cutaneous malignant melanoma (CMM), is the most frequent Cancer worldwide. It is amenable to early detection, and screening for Skin Cancer has the potential to reduce mortality and morbidity. However, there are no recommendations for population-based Skin Cancer screening programmes due to the lack of evidence for the effectiveness from epidemiological studies. In 2008 the first nationwide screening programme for NMSC and CMM in the world was established in Germany. The decision for implementing such a programme was based on the results and evidence of a pilot study that was conducted from 2003 to 2004. The pilot study revealed that a population-based screening programme for Skin Cancer is feasible and effective. Careful evaluation of the nationwide programme is crucial to generate strong evidence for long-term public health benefits.

  • Systematic Skin Cancer screening in Northern Germany
    Journal of the American Academy of Dermatology, 2011
    Co-Authors: Eckhard W. Breitbart, Annika Waldmann, Sandra Nolte, Marcus Capellaro, Ruediger Greinert, Beate Volkmer, Alexander Katalinic
    Abstract:

    Background The incidence of Skin Cancer is increasing worldwide. For decades, opportunistic melanoma screening has been carried out to respond to this burden. However, despite potential positive effects such as reduced morbidity and mortality, there is still a lack of evidence for feasibility and effectiveness of organized Skin Cancer screening. Objective The main aim of the project was to evaluate the feasibility of systematic Skin Cancer screening. Methods In 2003, the Association of Dermatological Prevention was contracted to implement the population-based SCREEN project (Skin Cancer Research to Provide Evidence for Effectiveness of Screening in Northern Germany) in the German state of Schleswig-Holstein. A two-step program addressing malignant melanoma and nonmelanocytic Skin Cancer was implemented. Citizens (aged ≥20 years) with statutory health insurance were eligible for a standardized whole-body examination during the 12-month study period. Cancer registry and mortality data were used to assess first effects. Results Of 1.88 million eligible citizens, 360,288 participated in SCREEN. The overall population-based participation rate was 19%. A total of 3103 malignant Skin tumors were found. On the population level, invasive melanoma incidence increased by 34% during SCREEN. Five years after SCREEN a substantial decrease in melanoma mortality was seen (men: observed 0.79/100,000 and expected 2.00/100,000; women: observed 0.66/100,000 and expected 1.30/100,000). Limitations Because of political reasons (resistance as well as lack of support from major German health care stakeholders), it was not possible to conduct a randomized controlled trial. Conclusions The project showed that large-scale systematic Skin Cancer screening is feasible and has the potential to reduce Skin Cancer burden, including mortality. Based on the results of SCREEN, a national statutory Skin Cancer early detection program was implemented in Germany in 2008.

Carolyn J. Heckman - One of the best experts on this subject based on the ideXlab platform.

  • Multiple Skin Cancer risk behaviors in the U.S. population.
    American Journal of Preventive Medicine, 2008
    Co-Authors: Elliot J. Coups, Sharon L. Manne, Carolyn J. Heckman
    Abstract:

    Background The incidence of all types of Skin Cancer has increased over the past 3 decades in the United States. Increased Skin Cancer risk is associated with exposure to ultraviolet radiation. This study examined the age-stratified prevalence and correlates of multiple Skin Cancer risk behaviors (infrequent use of sun-protective clothing, staying in the sun when outside on a sunny day, infrequent use of sunscreen, indoor tanning, and receiving a sunburn) among U.S. adults. Methods 28,235 adults participating in the 2005 National Health Interview Survey (NHIS) answered questions regarding sun-protection behaviors, indoor tanning in the past year, and sunburns in the past year. Examined correlates included geographic location, demographics, healthcare access, BMI, physical activity, smoking, alcohol use, melanoma family history, perceived Cancer risk, Skin sensitivity to the sun, and receipt of a total Skin exam. Results The most commonly reported Skin Cancer risk behaviors were infrequent use of sun-protective clothing and infrequent use of sunscreen. The majority of individuals reported multiple Skin Cancer risk behaviors. Although significant correlates varied according to age, individuals reporting more risk behaviors were more likely younger, residing in the Midwest, male, non-Hispanic white, less-educated, smokers, risky drinkers, and had Skin that was less sun-sensitive. Conclusions The majority of the U.S. population engage in multiple Skin Cancer risk behaviors. A comprehensive approach to Skin Cancer prevention requires attention to multiple Skin Cancer risk behaviors that are common in the U.S. population.

Robert S. Kirsner - One of the best experts on this subject based on the ideXlab platform.

  • reported Skin Cancer screening of us adult workers
    Journal of The American Academy of Dermatology, 2008
    Co-Authors: William G. Leblanc, Robert S. Kirsner, Kristopher L. Arheart, David J. Lee, Liat Vidal, Alberto J Cabanmartinez, Kathryn E Mccollister, Katherine Chungbridges, Sharon L Christ, John D Clark
    Abstract:

    Background Early detection of Skin Cancer by Skin examination may reduce its associated morbidity and mortality, in particular for workers routinely exposed to sun. Objectives We sought to describe the proportion of US workers reporting Skin Cancer screening examination in a representative sample of the US worker population in the National Health Interview Survey. Methods Report of Skin Cancer examination in the 2000 and 2005 National Health Interview Survey Cancer control supplements were examined by a range of variables. Results Lifetime and 12-month reported clinical Skin examination prevalence was 15% and 8%, respectively. Workers with elevated occupational exposure to ultraviolet light were less likely to have ever received a Skin examination than the average US worker. Logistic regression analysis identified occupational category and age, sex, race, education level, health insurance, and sun-protective behavior as significant independent correlates of Skin Cancer examination. Limitations A limitation is potential healthy worker effect and underestimation of Skin Cancer screening with self-reported data. Conclusions Routine examination by primary care physicians frequently does not include a thorough Skin examination. Physicians should be even more vigilant with patients at increased risk of excessive occupational sun exposure, as early detection of Skin Cancer by periodic Skin examination decreases morbidity and can improve survival.

  • Skin Cancer screening by dermatologists: prevalence and barriers.
    Journal of the American Academy of Dermatology, 2002
    Co-Authors: Daniel G. Federman, Jeffrey D. Kravetz, Robert S. Kirsner
    Abstract:

    Abstract Background: The incidence of Skin Cancers is increasing at an alarming rate, and there is currently no consensus by major health policy organizations regarding Skin Cancer screening. It has previously been shown that primary care physicians do not screen a majority of patients for Skin Cancer. Objective: This study was undertaken to determine the prevalence of Skin Cancer screening among dermatologists and to detect barriers to screening. As a secondary objective, we set out to determine the prevalence of dermatoscopy use. Methods: With the use of membership data from the 1999-2000 directory of the American Academy of Dermatology, a random sample of 464 American dermatologists was surveyed to assess their Skin Cancer screening practices and perceived obstacles to this practice. We then determined whether differences in knowledge of Skin Cancer screening recommendations, emphasis of Skin Cancer screening in training, or physician age affected the prevalence of screening. Results: A total of 190 dermatologists responded (41%). Fifty-seven respondents (30%) reported performing full-body Skin Cancer screening on all of their adult patients and 93 more (49%) reported screening only patients perceived to be at increased risk. Eighty respondents (42%) reported lack of time as an impediment to screening. Only 18 (9%) did not screen patients because of potential patient embarrassment, whereas 17 (9%) did not perform screening because of lack of financial reimbursement. Sixty-two dermatologists (33%) reported being aware of official Skin Cancer screening recommendations, but they were not more likely to screen all patients ( P = .64) or partake in screening of all patients or only those at increased risk ( P = .84). One hundred nineteen respondents (63%) reported that Skin Cancer screening was emphasized during their medical training and they were more likely to screen all patients ( P = .04) or either all or high-risk patients ( P = .02). Younger age groups of dermatologists were significantly more likely to screen all patients for Skin Cancer ( P = .03). Twenty-two percent of respondents reported using dermatoscopy for suspicious lesions. Conclusion: Dermatologists report a high rate of screening for Skin Cancer despite not having knowledge of Skin Cancer screening recommendations. Inadequate time to perform full-body Skin examinations and lack of emphasis during training were identified as possible barriers to this practice. (J Am Acad Dermatol 2002;46:710-4.)

  • Skin Cancer screening in primary care: Prevalence and barriers
    Journal of the American Academy of Dermatology, 1999
    Co-Authors: Robert S. Kirsner, Sara Muhkerjee, Daniel G. Federman
    Abstract:

    Background: Skin Cancer incidence is increasing, but whether primary care providers routinely screen for Skin Cancer is not known. Objective: We assessed whether primary care practitioners are performing Skin Cancer screening within the context of primary care and whether barriers exist that might act as impediments to the implementation of this practice. Methods: A total of 465 primary care providers belonging to their respective county medical societies in either New Haven County, Connecticut, or Miami-Dade County, Florida were randomly selected and surveyed by mailed questionnaire regarding their Skin Cancer screening practices. Results: Only 31% of responding physicians reported performing Skin Cancer screening on all of their adult patients. Of those not performing Skin Cancer screening on all adult patients, only 31% report performing screening on high-risk patients. Almost half of physicians reported that they do not perform Skin Cancer screening. We found that physicians' lack of confidence in identifying suspect lesions was a common barrier. Fear of patient embarrassment, inadequate lighting, or lack of studies demonstrating mortality benefits were not frequent deterrents. Furthermore, there was no statistical difference in screening rates between the more northern latitude and the more southern latitude. Conclusion: Skin Cancer screening is not being performed within the context of primary care visits. Barriers exist that may impede Skin Cancer screening.

V. Schenkelberger - One of the best experts on this subject based on the ideXlab platform.

  • Occupation and Skin Cancer
    Melanoma Research, 1996
    Co-Authors: Ingo Schindera, V. Schenkelberger
    Abstract:

    We have restricted the following subject to occupation, UV-radiation and Skin Cancer. Other environmental or occupational carcinogens such as tar, tar products or anorganic arsenic will not be taken into account. Their relevance to Skin Cancer is well known. Although malignant Skin tumors caused by tar products and arsenic are acknowledged as an occupational disease in Germany since many years, they no longer play an important role today in comparison to the large and increasing number of occupational contact dermatitis. Artifical UV-radiation which can develop from working with electrical welding, for example, will not be discussed.