Cancer of the skin is the fifth most frequently seen new cancer illness in Germany. For the year 2012, the German Cancer Registry has recorded 20,820 new cases of malignant melanoma. Of particular importance for this type of cancer is establishing an early diagnosis. "If the illness is recognized early, treatments can be very effective and the chance of becoming healthy again is quite high," explains Prof. Dr. Stefanie Klug, Full Professor at the TUM Department of Epidemiology. If the illness is recognized only late, on the other hand, the chances for survival decrease.
Publication in the Open Access Journal "BMC Cancer"
With this in mind, the TUM Department of Epidemiology in cooperation with the Workgroup of German Tumor Centers e.V. (ADT) has investigated the diagnosis of malignant melanoma in Germany. A paper was now published in the specialist periodical "BMC Cancer". The Open Access Journal has an Impact Factor of 3.77.
In July, 2008 a program on the early diagnosis of skin cancer began in Germany as the first country throughout Europe. Although investigations of the skin within the scope of the statutory early cancer diagnosis could be carried out before this time, this was not with a specialist actually responsible for this. Since 2008, individuals over the age of 35 can now undergo a screening every two years with the dermatologist as well as with a specially certificated physician. This examination is covered by the health insurance schemes. "With this in mind, we wanted to determine whether this screening has already led to changes so that the diagnosis occurs at an earlier stage - which clearly improves the prognosis," explains Dr. Olaf Schoffer, scientific staff member of the TUM Department of Epidemiology.
A unique collection of records for Germany to date
For this purpose, researchers have analyzed the data from a total of 61,895 people who were diagnosed as having a "malignant melanoma" between 2002 and 2011. The data collected came from 24 population-related as well as 4 facility-related clinical cancer registries. "The data set represents a landmark in the evaluation of clinical cancer registry data," explains Prof. Klug. After all, the data of the epidemiological cancer registry would usually only be used for studies in this area. "The data of the clinical registries are more extensive, for example, with a look at methods of treatment that are really carried out," says Schoffer. Through cooperation with the ADT, the research group could now generate a data record for Germany which is now unique.
Aside from the evaluation of 61,895 cases of melanoma between 2002 and 2011, a clear increase in the diagnosis at an early stage (UICC I) could be seen for this period. "We could show that the prognostically favorable diagnosis of stage I has increased over time. However, the late and prognostically unfavorable stages III and IV for the same period have not decreased," explains Schoffer.
With a look at the question of changes resulting from skin cancer screening since 2008, it was not possible to define any clear effect. "The findings indicate that the screening primarily results in additionally diagnosed melanomas in an earlier stage. However, a further effect of the screening to be expected would also have been a reduction in the number of diagnoses of later stages and this could not be confirmed during this time period," explains Klug.
In line with this, Schoffer summarizes, "We were not able to confirm any significant shifts in the diagnosis of stages since the introduction of the screening. The melanomas diagnosed in the screening, however, were seen to be in an earlier stage with a significantly higher chance. Now, the long-term effects of the screening will have to be examined, since the period of time between 2008 and 2011 was still relatively short."
To the Homepage of the TUM Department of Epidemiology
To the BMC-Cancer paper on malignant melanoma
Contact:
Prof. Dr. Stephanie Klug
Lehrstuhl für Epidemiologie
Uptown München, Campus C
Georg-Brauchle Ring 56
80992 Munich
Tel.: 089 289 24951
Email: Sekretariat.Klug(at)tum.de
Text: Fabian Kautz
Photo: TUM