TY - JOUR
T1 - Evaluation of skin cancer screening in Germany - a Microsimulation
AU - Baltus, Hannah
AU - Hübner, Joachim
AU - Garbe, Claudia
AU - Hagenström, Kristina
AU - Rohr, Maren
AU - Hischke, Sandra
AU - Augustin, Jobst
AU - Augustin, Matthias
AU - Katalinic, Alexander
AU - Eisemann, Nora
N1 - © 2024 The Author(s). Journal der Deutschen Dermatologischen Gesellschaft published by John Wiley & Sons Ltd on behalf of Deutsche Dermatologische Gesellschaft.
PY - 2024
Y1 - 2024
N2 - BACKGROUND: Comprehensive skin cancer screening was introduced in Germany in 2008. It is unclear whether subsequently observed changes in the epidemiology of malignant melanoma (MM), squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) are due to the screening. Simulation models are used to compare different screening scenarios with each other and with observed incidence and mortality trends.METHODS: A microsimulation model for MM, SCC, and BCC was programmed and validated separately by sex on skin cancer-specific mortality data. In addition to the currently practiced screening (biennial offer, annual participation probability 15%), triennial screening, screening with increased participation, e.g., via invitation, and no screening were simulated. Incidence, mortality, costs, and life-years gained were simulated for 30 years from the start of screening.RESULTS: Compared with no screening, mortality is reduced by 13.8% in the simulation with current conditions. This effect occurs in the first years after screening starts before reaching a stable level. More screening allows for further increases in incidence, life-years gained, and costs and decreases in mortality. Comparing simulated and observed effects shows little agreement.CONCLUSIONS: The model is useful for comparing screening scenarios to identify potential optimization opportunities in SCS. Additional, especially risk-adapted, screening scenarios should be investigated.
AB - BACKGROUND: Comprehensive skin cancer screening was introduced in Germany in 2008. It is unclear whether subsequently observed changes in the epidemiology of malignant melanoma (MM), squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) are due to the screening. Simulation models are used to compare different screening scenarios with each other and with observed incidence and mortality trends.METHODS: A microsimulation model for MM, SCC, and BCC was programmed and validated separately by sex on skin cancer-specific mortality data. In addition to the currently practiced screening (biennial offer, annual participation probability 15%), triennial screening, screening with increased participation, e.g., via invitation, and no screening were simulated. Incidence, mortality, costs, and life-years gained were simulated for 30 years from the start of screening.RESULTS: Compared with no screening, mortality is reduced by 13.8% in the simulation with current conditions. This effect occurs in the first years after screening starts before reaching a stable level. More screening allows for further increases in incidence, life-years gained, and costs and decreases in mortality. Comparing simulated and observed effects shows little agreement.CONCLUSIONS: The model is useful for comparing screening scenarios to identify potential optimization opportunities in SCS. Additional, especially risk-adapted, screening scenarios should be investigated.
UR - http://www.scopus.com/inward/record.url?scp=85208547971&partnerID=8YFLogxK
UR - https://www.mendeley.com/catalogue/4e6cc0d1-8c44-31d8-a654-5158246ab34c/
U2 - 10.1111/ddg.15539
DO - 10.1111/ddg.15539
M3 - Journal articles
C2 - 39520317
SN - 1610-0379
JO - Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG
JF - Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG
ER -
