Skin Cancer Screening Programs: Are They Effective?
Skin cancer screening programs are designed to increase detection and improve treatment, but their effectiveness is mixed.
An anticipated 91,270 Americans will receive a diagnosis of malignant melanoma this year, and 9320 will die of the disease, according to the US National Cancer Institute.1 Incidence rates have climbed steadily in recent decades but there have been modest reductions in mortality since 2006, likely due in part to advances in targeted treatment options. The 5-year overall survival rate in the United States exceeds 90%.1 Melanoma incidence rates rose by 1.5% a year, on average, between 2006 and 2015 — but mortality rates declined by 1.2% per year during the same period.1
Skin cancer screening programs are intended to improve the chances of early detection and treatment of melanoma, but the evidence that they achieve that goal remains mixed.2,3 As a result, skin cancer screening recommendations vary between countries.4,5 The US Preventive Services Task Force (USPSTF) concluded in 2016 that the available research offered insufficient evidence to determine the potential harms — such as anxiety or overtreatment — and benefits of clinician-conducted visual skin cancer-screening examinations.2 Several US medical societies, including the American College of Physicians, American College of Preventive Medicine, and the American Cancer Society, do not recommend skin cancer screening.6
Germany established the world's first nationwide skin cancer screening program in 2008, yielding a modest and temporary drop in melanoma mortality.5 By 2014, the program had not achieved a decrease from 2007 melanoma mortality rates.5
In the United States, the American Academy of Dermatology's SPOTme® Skin Cancer Screening Program has provided more than 2 million no-fee, volunteer-led skin cancer screenings since it was established in 1985, leading to the detection of more than 30,000 suspected melanomas.6 It is one of the largest cancer screening programs, second only to the US Centers for Disease Control and Prevention's National Breast and Cervical Cancer Early Detection Program.6
A recent review of the SPOTme program's first 30 years of operation found that participating clinicians have performed approximately 100,000 screenings each year since 1990.6 That program has led to detection and diagnosis of melanomas among thousands of people, including the 9% of screenees overall — and 12% of those with a melanoma diagnosis — who were uninsured.6
“In all, 72% of the screenees met the US Prevention Services Task Force criteria for high risk of melanoma,” the researchers reported.6 “Among persons with clinically diagnosed melanoma, 47% would not have otherwise seen a doctor for a skin examination.”