Interval cancers after skin cancer screening : incidence, tumour characteristics and risk factors for cutaneous melanoma
Menée en Allemagne à partir de données portant sur 350 306 personnes ayant participé à un programme de dépistage du mélanome cutané entre 2003 et 2004 et à partir des données d'un registre des cancers sur la période 1999-2002, cette étude évalue, du point de vue du taux de mélanomes diagnostiqués 4 à 24 mois après l'examen de dépistage et du type de lésion au diagnostic, l'efficacité du programme de dépistage
Background : The rate of interval cancers is an established indicator for the performance of a cancer-screening programme.
Methods : We examined the incidence, tumour characteristics and risk factors of melanoma interval cancers that occurred in participants of the SCREEN project, which was carried out 2003/2004 in Schleswig-Holstein, Germany. Data from 350 306 SCREEN participants, who had been screened negative for melanoma, were linked to data of the state cancer registry. Melanoma interval cancers were defined as melanomas diagnosed within 4–24 months after SCREEN examination. Results were compared with melanomas of the pre-SCREEN era (1999–2002), extracted from the cancer registry.
Results : The overall relative incidence of melanoma interval cancers in terms of observed/expected ratio was 0.93 (95% CI: 0.82–1.05; in situ: 1.61 (1.32–1.95), invasive: 0.71 (0.60–0.84)). Compared with melanomas of the pre-SCREEN era, the interval melanomas were thinner and had a slightly greater proportion of lentigo maligna melanomas whereas nodular melanomas were less frequent.
Interpretation : The results indicate a moderate performance of the SCREEN intervention with an excess of in situ melanomas. In part, the findings might be due to specifics of the SCREEN project, in particular a short-term follow-up of patients at high risk for melanoma.
British Journal of Cancer , résumé, 2015