Early detection of cutaneous malignant melanoma in Britain.

A multidisciplinary approach to research has been one of the hallmarks of Walter Holland's outstanding career in medical research. Studies arising from evaluation of the Cancer Research Campaign's health education programme for the early detection of cutaneous malignant melanoma were reviewed at Walter's Festschrift because they illustrate the importance of the multidisciplinary approach and raise issues about medical screening which has been a special interest of Walter's The programme took place in 1987 in seven areas of England and Scotland with a target population of 3.6 million. The main aim of the evaluation study is to investigate the effect of the programme on mortality from melanoma. Interim effects on awareness about melanoma, workload and incidence rates of melanoma by stage are reviewed. The importance of collaboration between dermatologists, epidemiologists, histopathologists and health education specialists has been essential. However, the effectiveness of high profile campaigns alone to promote early detection of melanoma is uncertain and future initiatives should be evaluated in randomized controlled trials.