The relation between mortality from malignant melanoma and early detection in the Cancer Research Campaign Mole Watcher Study

Abstract

Summary Between 1987 and 1989 the Cancer Research Campaign funded a health education programme for the early detection of cutaneous malignant melanoma in the general population in 6 health districts of England and 1 health board in Scotland (population of 3 million). The intervention was evaluated by studying its effects on annual and cumulative mortality rates for melanoma. Population-based data on mortality from melanoma were collected in the intervention areas, the health regions covering those areas, and 5 other health regions of England from 1981 to 1996. Deaths from melanoma in cases diagnosed after the start of the intervention were used to study cumulative mortality rates. The annual mortality rates for melanoma, 1981 to 1996, showed no significant difference in their trends between the intervention areas, and other areas of England and Wales. After adjustment for pre-intervention rates, there was also no significant reduction in cumulative mortality from melanoma in the intervention areas compared with the non-intervention areas: rate ratio 1.2 (95% Cl 0.9-1.7) in men, 0.9 (95% Cl 0.7-1.3) in females. The lack of a significant reduction in melanoma mortality associated with the intervention raises questions about this approach to early detection and emphasises the need for new strategies.

Efficacy of a general practitioner training campaign for early detection of melanoma in France

“…These campaigns were regularly followed by an increase in melanoma incidence, associated in most cases with an increase in the proportion of thin melanomas. However, they generally failed to show a decrease in either melanoma‐related mortality and/or in incidence of thick melanomas . A recent American study concluded that surveillance and early detection efforts in the U.S.A. have not resulted in a substantial reduction of tumours with prognostically unfavourable thickness .…”

“…However, they generally failed to show a decrease in either melanoma-related mortality and/or in incidence of thick melanomas. [23][24][25][26][27][28][29] A recent American study concluded that surveillance and early detection efforts in the U.S.A. have not resulted in a substantial reduction of tumours with prognostically unfavourable thickness. 30 In this context, our results, although limited to a small geographical area, seem original and of interest.…”

Changing Trends in Numbers of Deaths from Malignant Melanoma in Japan, 1955–2000

“…Elderly individuals should be the focus of health promotion activities [1, 2], although the approach to early detection does not always result in a significant reduction in melanoma mortality [9]. …”

Early detection of cancer: Ideas for a debate

“…Early detection of melanoma can benefit from education of the general population to become aware of the early signs, targeted interventions on high-risk groups and individuals [19]. Targeted interventions can focus on very high-risk groups such as those with a family history of the disease or those with a phenotype, which carries a higher risk than the average population, such as those with fair skin or a large number of naevi.…”