Centre for Health Services Research, Faculty of Medicine, The University of Queensland.
Sydney School of Public Health and Melanoma Institute Australia, The University of Sydney, New South Wales.
Aust N Z J Public Health. 2020 Apr;44(2):111-115. doi: 10.1111/1753-6405.12972. Epub 2020 Mar 19.
A Melanoma Screening Summit was held in Brisbane, Australia, to review evidence regarding current approaches for early detection of melanomas and explore new opportunities.
Formal population-based melanoma screening is not carried out in Australia, but there is evidence of considerable opportunistic screening as well as early detection. Biopsy rates are rising and most melanomas are now diagnosed when in situ. Based on evidence review and expert opinion, the Summit attendees concluded that there is currently insufficient information in terms of comparative benefits, harms and costs to support change from opportunistic to systematic screening. Assessment of gains in precision and cost-effectiveness of integrating total body imaging, artificial intelligence algorithms and genetic risk information is required, as well as better understanding of clinical and molecular features of thin fatal melanomas.
Research is needed to understand how to further optimise early detection of melanoma in Australia. Integrating risk-based population stratification and more precise diagnostic tests is likely to improve the balance of benefits and harms of opportunistic screening, pending assessment of cost-effectiveness. Implications for public health: The Summit Group identified that the personal and financial costs to the community of detecting and treating melanoma are rising, and this may be mitigated by developing and implementing a more systematic process for diagnosing melanoma.
在澳大利亚布里斯班举行了一次黑色素瘤筛查峰会,旨在回顾有关黑色素瘤早期检测的现有方法的证据,并探索新的机会。
澳大利亚没有进行正式的基于人群的黑色素瘤筛查,但有大量机会性筛查和早期检测的证据。活检率正在上升,大多数黑色素瘤现在处于原位时就被诊断出来。根据证据审查和专家意见,峰会与会者得出结论,目前关于比较效益、危害和成本的信息不足,不足以支持从机会性筛查转变为系统性筛查。需要评估整合全身成像、人工智能算法和遗传风险信息的精确性和成本效益,以及更好地了解薄型致命黑色素瘤的临床和分子特征。
需要研究如何进一步优化澳大利亚黑色素瘤的早期检测。整合基于风险的人群分层和更精确的诊断测试可能会改善机会性筛查的效益和危害的平衡,但需要评估成本效益。对公共卫生的影响:峰会小组确定,检测和治疗黑色素瘤给社区带来的个人和经济成本正在上升,通过开发和实施更系统的黑色素瘤诊断程序,可能会减轻这种情况。