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A local education campaign on early diagnosis of malignant melanoma

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Abstract

The growing incidence of all kinds of skin cancer is a worldwide phenomenon observed in the last decades. Malignant melanoma is of special concern because of its high death rate when in an advanced stage, poor therapeutic response and fast growing incidence. Malignant melanoma is primarily located on the skin and therefore well suited for early cancer detection. The “Deutsche Dermatologische Gesellschaft” carried out a highly successful information campaign in Germany. Under this roof we organised different campaigns. Following considerable success in a campaign in 1989, a total of 1467 patients were examined and advised in the course of a local initiative (Education Campaign “Black cancer”) in the city of Bochum (∼ 400,000 inhabitants) in the summer of 1991. In addition to full body examinations, important data were collected concerning the degree of knowledge about skin cancer, epidemiology, and the risk of skin cancer in general. As a result of the clinical examinations, 73 patients with strongly suspected skin cancer have been treated. Within this group, 14 malignant melanomas (1.0%) as well as 34 basal cell carcinomas (1.9%) were diagnosed. These numbers highly exceed the assumed risk incidence of skin cancer in Germany. Even on the assumption that the population was selective it is to be feared that a high number of individuals with skin cancer remain undetected and untreated. The majority of persons seeking advice had been motivated by the local media. The response and results of this local campaign indicate that further preventive measures for the general population in Europe are conceivable, meaningful and urgently needed.

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References

  1. ArmstrongB.K. (1984): Melanoma of the skin - Br. Med. Bull. 40: 346–350.

    Google Scholar 

  2. AugustonA., StiernerU., RosendahlI. and SuurkülaM. (1990): Melanocytic nevi in sun-exposed and protected skin in melanoma patients and controls -Acta Der. Venerol. (Stockh.) 71: 512–517.

    Google Scholar 

  3. AziziE., ModanM., KushelevskyA.P. and Schewach-MoilletM. (1987): A more reliable index of sunscreen protection based on life table analysis of individual sun protection factors - Br. J. Dermatol. 116: 693–702.

    Google Scholar 

  4. AziziE., LuskyA., KushelevskyA.P. and Shewach-MilletM. (1988): Skin type, hair colour and freckles are predictors of decreased minimal erythema ultraviolet radiation dose - J. Am. Acad. Dermatol. 19: 32–38.

    Google Scholar 

  5. BanksB.A., SilvermanR.A.,SchwartzR.H. and Tunnessen (1992): Attitudes of teenagers towards sun exposure and sunscreen use - Pediatrics 89: 1.

    Google Scholar 

  6. BeitnerH., RingborgU., WennerstenG. and LagerlofB. (1981): Further evidence for increased light sensitivity in patients with malignant melanoma - Br. J. Dermatol. 104: 289–294.

    Google Scholar 

  7. BeitnerH., NorellS.E., RingborgU., WennerstenG. and MattsonB. (1990): Malignant melanoma: etiologic importance of individual pigmentation and sun exposure - Br. J. Dermatol. 122: 43–51.

    Google Scholar 

  8. BeralV. and RobinsonN. (1981): The relationship of malignant melanoma, basal and squamous skin cancers to indoor and outdoor work - Br. J. Cancer. 44: 891–896.

    Google Scholar 

  9. BernA. and RassnerG. (1988): Das Maligne Melanom oft zu spät entdeckt und behandelt - Z. Hautkr. 63: 273–281.

    Google Scholar 

  10. Blackford S. and Roberts D. (1992): What do children know about the effects of sun on their skin? In: The environmental threat to the skin; Marks R. Plewig G. pp. 43–45.

  11. BlakeR.S. (1985): Skin Care and Melanomas - Med. J. Austr. 23: 634.

    Google Scholar 

  12. BoyceJ.A. and BernardJ.D. (1987): Routine total skin examination to detect malignant melanoma - J. Gen. Intern. Med. 35: 59–61.

    Google Scholar 

  13. BreslowA. (1970): Thickness, cross-sectional areas and depth of invasion in the prognosis of cutaneous melanoma - Ann. Surg. 172: 902–908.

    Google Scholar 

  14. Brodthagen H. (1982): Malignant melanoma caused by UV-A suntan bed? - Acta. Derm. Venereol. (Stockh) 62: 356–357.

    Google Scholar 

  15. BrownG., OsborneJ., LondonS. and FletscherA. (1990): The initial effect on workload and outcome of a public education campaign on early diagnosis and treatment of malignant melanoma in Leicestershire -Br. J. Dermatol. 122: 53–59.

    Google Scholar 

  16. ColeP. and MorrisonA.S. (1980): Basic issues in population screening for cancer - JNCI 64:1263–1272.

    Google Scholar 

  17. DiffeyB.L. (1987): Analysis of the risk of skin cancer from sunlight and solaria in subjects living in northern Europe - Photodermatol. 4: 118–126.

    Google Scholar 

  18. DohertyV.R. and MackieR.M. (1988): Experience of a public education program on early detection of cutaneous malignant melanoma - Br. Med. J. 297: 388–391.

    Google Scholar 

  19. DubinN., MosesonM. and PasternackB.S. (1986): Epidemiology of malignant melanoma. Pigmentary traits, ultraviolet radiation, and the identification of high-risk populations - Recent Results in Cancer Research 102: 56–75.

    Google Scholar 

  20. ElwoodJ.M. (1989): Epidemiology and control of melanoma in white population and in Japan - J. Invest. Dermatol. 92 (5 Suppl.): 214s–221s.

    Google Scholar 

  21. ElwoodJ.M.1, CookeK.R., CoombsB.D., CoxB., HandJ.E. and SkeegD. C. (1988): A strategy for the control of malignant melanoma in New Zealand - N. Z. Med. J. 101: 602–604.

    Google Scholar 

  22. EvansR.D., KopfA. W., LewR.A., RigelD.S., BartR.S., FriedmannR.J. and RiversJ.K. (1988): Risk factors of the development of malignant melanoma. I: Review of case-control studies - J. Dermatol. Surg. Oncol. 14: 393–408.

    Google Scholar 

  23. Fabry H. (1990): Probleme der ärztlichen Begutachtung aus der Dermatologie. In: Fritze E. (edit.) Die ärztliche Begutachtung, Steinkopf Verlag Dermstadt pp. 651–691.

  24. GallagherR.P., ElwoodJ.M. and HillG.B. (1986): Risk factors for cutaneous malignant melanoma: The Western Canada melanoma study - Recent Results Cancer Research 102: 38–55.

    Google Scholar 

  25. GallagherR.P., ElwoodJ.M., ThrellfallW., SpinelliJ.J., FinchamS. and HillG.B. (1987): Socioeconomic status, sunlight exposure, and risk of malignant melanoma: The westen Canada melanoma study - J. Nat. Cancer Inst. 79: 647–652.

    Google Scholar 

  26. GallagherR.P., McLeanD.I. and YangC.P. (1990): Suntan, sunburn, and pigmentation factors and the frequency of acquired melanocytic nevi in children -Arch. Dermatol. 126: 770–776.

    Google Scholar 

  27. GarbeC., KrügerS., StadlerR., Guggenmoos-HolzmannI. and OrfanosC.E. (1989): Markers and relative risk for developing malignant melanoma in a German population - Int. J. Dermatol. 28: 517–523.

    Google Scholar 

  28. GarbeC. and OrfanosE. (1990): Epidemiologie des malignen Melanoms - Hautarzt 41 (suppl. I): 71–79.

    Google Scholar 

  29. Garbe C. and Orfanos E. (1992): Epidemiology of malignant melanoma in central Europe. Risk factors and prognostic predictors.

  30. GoldsmithM.F. (1987): Unusual moles play a role in new strategies for predicting and preventing malignant melanoma - JAMA 257: 894–895.

    Google Scholar 

  31. Graham-BrownR.A.C., OsborneJ.E., LondonS.P., FletcherA., ShawD., WilliamsB. and BowryV. (1990): The initial effects on workload and outcome of public education campaign on early diagnosis and treatment of malignant melanoma in Leicestershire -Br. J. Dermatol. 122: 53–59.

    Google Scholar 

  32. GreenA., BainC., McLennanN. and SiskindV. (1986): Risk factors for cutaneous melanoma in Queensland- Recent Results Cancer Res. 102: 76–97.

    Google Scholar 

  33. HerseyP., HasicE. and EdwardsA. (1983): Immunological effects of solarium exposure -Lancet 1: 545–548.

    Google Scholar 

  34. HoffmannK., MatthesU., StückerM., SegerlingM. and AltmeyerP. (1989): “Prevention Week in Bochum for malignant melanoma information” - Öff. Gesundh. Wes. 52: 9–13.

    Google Scholar 

  35. HoffmeisterH., BertzJ. and GarbeC. (1989): Entwicklung von Inzidenz und Mortalität des Malignen Melanoms in der Bundesrepublik Deutschland - Hautarzt 40: 377–379.

    Google Scholar 

  36. HollyE.A., KellyJ.W., ShallS.N. and ChiuS.H. (1987): Number of melanocytic nevi as a major risk factor for malignant melanoma - J. Am. Acad. Dermatol. 17: 459–468.

    Google Scholar 

  37. HolmanC.D.J. and ArmstrongB.K. (1981): Pigmentary traits, ethnic origin, benign nevi, and family history as risk factors for cutaneous malignant melanoma - JNCI 72: 257–266.

    Google Scholar 

  38. IlligL. (1987): Epidemiological aspects of malignant melanoma - Anticancer Res. 7: 1309–1313.

    Google Scholar 

  39. IlligL., PaulE. and HundeikerM. (1983): Public und professional melanoma education. Ein deutsches Modell zur Verbesserung der Melanom-Früherkennung bzw. Erfassung mit publizistichen Methoden auf dem Boden korrigierter Vorstellungen über Melanom u nd Naevus - Z. Hautkr. 58: 73–112.

    Google Scholar 

  40. Jones R.R. (1992): Ozone depletion: historical review and prospects for the twenty-first century. In: The environmental threat to the skin; Marks R. Plewig G. pp. 10–15.

  41. JungE.G. (1989): Wie kann man Melanome verhindem? - Dtsch. Med. Wochenschr. 114: 393–397.

    Google Scholar 

  42. JungE.G. (1990): Lichtbiologie der Melanome -Hautarzt 41 (Suppl. X): 79–85.

    Google Scholar 

  43. KaidbeyK.H., AginP.P., SayreR.M. and KligmanA.M. (1979): Photoprotection by melanin, a comparison of black and Caucasian skin - J. Am. Acad. Dermatol. 1: 249–260.

    Google Scholar 

  44. KaminesterL.H. (1980): Suntanning centers - JAMA 244: 1258–1259.

    Google Scholar 

  45. KleppO. and MagnusK. (1979): Some environmental and body characteristics of melanoma patients. A case-control study - Int. J. Cancer 23: 482–486.

    Google Scholar 

  46. KingP.H., MurfinG.D., YanegisakoK.L., WagstaffD.A., PutnamG.L., HajasF.L. and BergerS.C. (1983): Skin cancer, melanoma knowledge and behaviour in Hawaii: changes during a community-based cancer control program - Prog. Clin. Biol. Res. 130: 135–144.

    Google Scholar 

  47. KohH.K., LewR.A. and ProutM.N. (1989): Screening for melanoma/skin cancer: theoretic and practical considerations - J. Am. Acad. Dermatol. 20: 159–175.

    Google Scholar 

  48. KohH.K. (1991): Cutaneous Melanoma - N. Eng. J. Med. 325: 171–182.

    Google Scholar 

  49. Kopf A.W., Kripke M.L. and Stern R.S. (1984): Sun and malignant melanoma - J. Am. Acad. Dermatol. pp. 674–684.

  50. KopfA.W. (1985): Prevention of malignant melanoma - Dermatol. Clin. 3: 358–360.

    Google Scholar 

  51. KopfA.W. (1988): Prevention and early detection of skin cancer and melanoma - Cancer 62 (8Suppl.): 1791–1795.

    Google Scholar 

  52. KrickerA., ArmstrongB.K., EnglishD.R. and HananP.G. (1991): Pigmentary and cutaneous risk factors for non-melanotic skin cancer - Int. J. Cancer 48: 650–662.

    Google Scholar 

  53. LewR.A., SoberA.J. and CookN. (1983): Sun exposure habits in patients with cutaneous melanoma: a case control study - J. Dermatol. Surg. Oncol. 9: 981–986.

    Google Scholar 

  54. LookingbillD.P. (1988): Yield from a complete skin examination - Am. Acad. Dermatol. 18: 31–37.

    Google Scholar 

  55. Lynch H., LynchJ. and KraftC. (1973): A new approach to cancer screening and education -Geriatrics 28: 152–157.

    Google Scholar 

  56. LynchH.T., FusaroR.M. and DanesB.S. (1983): A review of hereditary malignant melanoma including biomarkers in familial/atypical multiple mole melanoma syndrome - Cancer Genet. Cytogenet. 8: 325–358.

    Google Scholar 

  57. MacKieR.M. and AtchisonT. (1982): Severe sunburn and subsequent risk of primary cutaneous malignant melanoma in Scotland - Br. J. Cancer 46: 955–960.

    Google Scholar 

  58. McLeodG.R. (1988): Control of melanoma in highrisk populations. In: Elwood J.M. (edt.), Melanoma and nevi, Pigment Cell Vol. 9 Karger (Basel), p. 133.

    Google Scholar 

  59. Mc Leod G.R., Davis N.C., Little H.J., Green A. and Chaini D. (1988): Das Maligne in Queensland, Australia: Erfahrungen del Queensland Melanoma Projekt. In: Balch C.M., Milton G.W. -“Hautmelanome”, Springer Verlag, pp. 250–258.

  60. MillerA.B. (ed) (1985): Screening for cancer -Academic Press, Orlando, Fla.

    Google Scholar 

  61. MorrisonA. (1985): Screening in chronic disease -Oxford University Press, New York.

    Google Scholar 

  62. NathansonC.A. (1977): Sex roles as variables in preventive health behaviour - J. Community Health 3: 142–155.

    Google Scholar 

  63. NesserP., TorhorstJ. and RufliT.H. (1988): Früherfassung des Malignen Melanoms der Haut -Schweiz. Rundsch. Med. 77: 467–470.

    Google Scholar 

  64. NewmanS., NicholsS., FreerC. and IzzardL. (1988): How much do the public know about moles, skin cancer and malignant melanoma? The results of a postal survey - Comm. Med. 41: 351–357.

    Google Scholar 

  65. OsterlindA., EngholmG. and JensenO.M. (1988): Trends in cutaneous malignant melanoma in Denmark, 1943–1982, by anatomic side - APMIS 96: 953–963.

    Google Scholar 

  66. OsterlindA., Hou-JensenK. and Moller-Jensen0. (1988): Incidence of cutaneous malignant melanoma in Denmark, 1978–1982. Anatomic side distribution, histologic types, and comparison with nonmelanoma skin cancer - Br. J. Cancer 58: 385–391.

    Google Scholar 

  67. ParkinD.M. and DyaN.E. (1985): Evaluation and planning screening programs - IARC Sci. Publ. 66: 45–63.

    Google Scholar 

  68. PaulE. and RauhM. (1988): Melanom Epidemiologie in Mittelhessen - Trend-Entwicklungen and deren möglichen Ursachen - Hautarzt 40: 378–381.

    Google Scholar 

  69. PierceT., MossE. and SamsWM. (1986): Hazards of ultraviolet light-radiation — particularly articificial suntanning devices - J. Environ. Health 49: 76–80.

    Google Scholar 

  70. PresserS.E. and TaylorJ.R. (1987): Clinical diagnostic accuracy of basal cell carcinoma - J. Am. Acad. Dermatol. 16: 988–990.

    Google Scholar 

  71. ProrokP.C., HankeyB. and BundyB. (1981): Concepts and problems in the evaluation of screening programs - J. Chronic. Dis. 34: 150–171.

    Google Scholar 

  72. RedmanJ.C. (1987): Stratospheric ozone depletion. A proposed solution to the problem - Am. J. Dermatopathol. 9: 457–458.

    Google Scholar 

  73. RemyW. and VogtH.J. (1989): Hauttumoren und Sonnenexposition - Dt. Dermatol. 37: 897–900.

    Google Scholar 

  74. RigelD.S., FriedmanR.J. and KopfA. W. (1986): Importance of complete cutaneous examination for the detection of malignant melanoma - J. Am. Acad. Dermatol. 14: 857–860.

    Google Scholar 

  75. RoushG.C., NordlundJ.J., ForgetB., GruberS.B. and KirkwoodJ.M. (1988): Independence of dysplastic nevi from total nevi in determining risk for nonfamilial melanoma - Prev. Med. 17: 273–279.

    Google Scholar 

  76. SchaubergerG. and KeckF. (1990): Ein Beitrag zur bestimmung der solaren UV-Belastung der Haut -Eine epidemiologische Betrachtung zur Aetiologie des Basalioms - Akt. Dermatol. 16: 298–302.

    Google Scholar 

  77. SiggC. and ScheyderU. W. (1988): Welche Malignen Melanome sind genetisch determiniert? - Hautarzt 40: 409–412.

    Google Scholar 

  78. Skin Cancer Foundation (USA) (1991): Skin Cancer facts and figures, 1991 - Official Bulletin, April 17th, 1991, New York.

  79. SprattJ.S. (1982): Epidemiology of screening of cancer - Cancer 6: 1–58.

    Google Scholar 

  80. StabergB., WulfH. C. and KlempP. (1938): The carcinogenic effect of UVA irradiation - J. Invest. Dermatol. 81: 517–519.

    Google Scholar 

  81. SternR.S., WeinsteinM. C. and BakerS. G. (1986): Risk reduction for non-melanoma skin cancer with childhood sunscreen use - Arch. Dermatol. 122: 537–545.

    Google Scholar 

  82. StreileinJ. W. (1991): Immunogenetic factors in skin cancer - N. Eng. J. Med. 325: 884–886.

    Google Scholar 

  83. SwerdlowA.J., EnglishJ. and MacKieM. (1986): Benign melanocytic nevi as a risk factor for malignant melanoma - Br. Med. J. 292: 1555–1559.

    Google Scholar 

  84. SwerdlowA.J., EnglischJ.S.C., MacKieR.M., 0'DoherryCJ and HuterJ.A. (1988): Fluorescent light, ultraviolet lamps and risk of cutaneous melanoma - Br. Med. J. 197 (1988): 647–650.

    Google Scholar 

  85. TempleF.U. (1983): Sunlight and Melanoma - J. Dermatol. Surg. Oncol. 9: 8–12.

    Google Scholar 

  86. UrbachF. (1983): Sunlight and melanoma - J. Dermatol. Surg. Oncol. 9: 679–680.

    Google Scholar 

  87. WahlbergP. and SkogE. (1991): The incidence of basal cell carcinoma in an area of Stockholm County during the period 1971–1980 - Acta. Derm. Venerol. (Stockh.) 71: 134–137.

    Google Scholar 

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  1. Dermatological Department of the Ruhr, University Bochum in St. Josef's Hospital Bochum, Gudrunstrasse 56 - D-44791, Bochum, Germany

    K. Hoffmann, Th. Dirschka, H. Schatz, A. Hoffmann & P. Altmeyer

  2. Public Health Service, City of Bochum, Germany

    M. Segerling

  3. Working Group of Local Health Insurances, Bochum, Germany

    Th. Tiemann

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  1. K. Hoffmann
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  2. Th. Dirschka
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Hoffmann, K., Dirschka, T., Schatz, H. et al. A local education campaign on early diagnosis of malignant melanoma. Eur J Epidemiol 9, 591–598 (1993). https://doi.org/10.1007/BF00211432

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