Wojcik K Y, Escobedo L A, Miller K A, Hawkins M, Ahadiat O, Higgins S, Wysong A, Cockburn Myles
Curr Dermatol Rep. 2017 Dec;6(4):316-324. doi: 10.1007/s13671-017-0205-6. Epub 2017 Nov 4.
To review skin cancer screening guidelines from major public health/medical organizations.
No consensus exists on whether or not screening to prevent skin cancer is warranted.
The best evidence of screening efficacy should come from population-based randomized trials, but is unlikely to exist due to feasibility constraints. Consequently, consensus should be built from observational/non-randomized designs, such as the SCREEN study in Germany. Current guidelines often focus on melanoma alone, while potential benefits of screening for non-melanoma skin cancers (NMSC) are largely overlooked. There may be less room for doubt regarding the value of screening, if both diseases were considered. Further, targeted approaches, i.e. screening only in high-risk populations, remain poorly defined and untested. Continuing to state that there is insufficient evidence to recommend screening leads to confusion about whether or not to screen, and is unlikely to result in substantial changes to the morbidity of NMSC and significant mortality from melanoma.
回顾主要公共卫生/医学组织的皮肤癌筛查指南。
对于是否有必要进行筛查以预防皮肤癌，目前尚无共识。
筛查效果的最佳证据应来自基于人群的随机试验，但由于可行性限制，此类证据不太可能存在。因此，应基于观察性/非随机设计达成共识，例如德国的SCREEN研究。当前指南通常仅关注黑色素瘤，而筛查非黑色素瘤皮肤癌（NMSC）的潜在益处大多被忽视。如果同时考虑这两种疾病，筛查价值的疑问可能会减少。此外，针对性方法，即仅在高危人群中进行筛查，仍定义不明确且未经测试。继续声称没有足够证据推荐筛查会导致对于是否进行筛查的困惑，并且不太可能使NMSC的发病率和黑色素瘤导致的显著死亡率发生实质性变化。
