Volunteer melanoma screenings. Follow-up, compliance, and outcome

Abstract

Background: Follow-up information on free melanoma screening clinics is not readily available.

Objective and methods: We studied the follow-up, compliance, and outcome of positive screenees after a screening campaign for melanoma in the Netherlands.

Results: Of the 4146 participants, 486 (11.7%) had a suspicious premalignant or malignant lesion warranting referral to his or her general physician indicating the proposed line of management. Participants with borderline lesions were not referred. Referral of borderline cases should have resulted in a considerable increase of the number of positive screenees (18.1%). All positive screenees but two gave permission for follow-up. Only 18 screenees (3.7%) were lost during follow-up. Moreover, one screenee with a presumed basal cell carcinoma and six screenees suspicious of having a premalignant lesion decided not to seek medical attention despite several reminders. The positive predictive value for melanoma was 17.2%, and for nonmelanoma skin cancers was 42.9%.

Conclusion: A selective referral policy may reduce the generated costs of melanoma screenings substantially. Adequate follow-up of positive screenees is mandatory in order to determine the ultimate yield and usefulness of such campaigns.