Melanoma screening clinics: are we detecting more melanomas or reassuring the worried well?

BACKGROUND

Melanoma screening clinics (MSCs) have been set up in the U.K. to help allay public anxiety about potential skin cancers, and to permit the early detection of thin melanomas, thus improving prognosis. Public health campaigns have led to increased awareness of melanoma and increased numbers of referrals to MSCs.

OBJECTIVES

To determine whether the MSC has had an impact on the number and thickness of melanomas detected over the past 8 years.

METHODS

Data was analysed retrospectively for all patients attending the MSC since it was set up in 1997, until the end of 2004. We categorized patients with melanoma according to Breslow thickness, examined trends in referral to the clinic and analysed changes in the proportion of patients with a new diagnosis of melanoma.

RESULTS

There were 15 970 patients who attended for screening; 403 primary invasive melanomas were detected, and 190 in situ melanomas. The number of new patients seen each year increased by over 230%, although the proportion of patients with melanoma detected declined. The Breslow thickness did not change over time.

CONCLUSIONS

Our experience suggests that public awareness has increased and that the general practitioner threshold for referral has fallen but there has been no reduction in the thickness of those melanomas diagnosed.