van Roekel Eline H, Verbeek André L M, Bonenkamp Han
Universiteit Maastricht, afd. Epidemiologie, Maastricht, the Netherlands.
Ned Tijdschr Geneeskd. 2012;156(26):A4456.
During the past few decades, the incidence of skin melanoma has increased greatly in the Netherlands. At the same time, the mortality from skin melanoma has increased, especially amongst older men. Because of the strong association between disease stage and prognosis, screening and an increase in awareness would appear to be good strategies for early detection of skin melanoma, thus reducing the disease burden. At the moment there is no conclusive evidence that mass screening of the population will decrease morbidity and mortality due to skin melanoma. In addition, there is uncertainty about the cost-effectiveness and about the organization of mass screening. In theory, screening of high-risk populations based on risk factors should be more efficient, but it is unclear how this selection should be carried out. Results of a mass screening project currently underway in Germany will provide more clarity on this subject. Until then, educating the general population and general practitioners about recognition of skin melanoma is of major importance in achieving early detection.
在过去几十年间，荷兰皮肤黑色素瘤的发病率大幅上升。与此同时，皮肤黑色素瘤的死亡率也有所增加，尤其是在老年男性中。由于疾病分期与预后之间存在密切关联，筛查以及提高 awareness（此处可能是“意识”，原文拼写有误）似乎是早期发现皮肤黑色素瘤的良好策略，从而减轻疾病负担。目前尚无确凿证据表明对人群进行大规模筛查会降低皮肤黑色素瘤导致的发病率和死亡率。此外，大规模筛查的成本效益以及组织实施方面存在不确定性。理论上，基于风险因素对高危人群进行筛查应该更有效，但尚不清楚应如何进行这种选择。德国目前正在进行的一个大规模筛查项目的结果将使这个问题更加明晰。在此之前，对普通民众和全科医生进行关于皮肤黑色素瘤识别的教育对于实现早期发现至关重要。
