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. 2001 Sep;85(6):803–807. doi: 10.1054/bjoc.2001.2012

The relation between mortality from malignant melanoma and early detection in the Cancer Research Campaign Mole Watcher Study

J Melia 1, S Moss 1, D Coleman 1, T Frost 2, R Graham-Brown 3, J A A Hunter 4, R A Marsden 5, A du Vivier 6, A P Warin 2, J White 7,1, S M Whitehead 8, M A Wroughton 9
PMCID: PMC2375070  PMID: 11556828

Abstract

Between 1987 and 1989 the Cancer Research Campaign funded a health education programme for the early detection of cutaneous malignant melanoma in the general population in 6 health districts of England and 1 health board in Scotland (population of 3 million). The intervention was evaluated by studying its effects on annual and cumulative mortality rates for melanoma. Population-based data on mortality from melanoma were collected in the intervention areas, the health regions covering those areas, and 5 other health regions of England from 1981 to 1996. Deaths from melanoma in cases diagnosed after the start of the intervention were used to study cumulative mortality rates. The annual mortality rates for melanoma, 1981 to 1996, showed no significant difference in their trends between the intervention areas, and other areas of England and Wales. After adjustment for pre-intervention rates, there was also no significant reduction in cumulative mortality from melanoma in the intervention areas compared with the non-intervention areas: rate ratio 1.2 (95% Cl 0.9–1.7) in men, 0.9 (95% Cl 0.7–1.3) in females. The lack of a significant reduction in melanoma mortality associated with the intervention raises questions about this approach to early detection and emphasises the need for new strategies. © 2001 Cancer Research Campaignhttp://www.bjcancer.com

Keywords: melanoma, early detection, mortality

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Selected References

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  1. Berwick M., Begg C. B., Fine J. A., Roush G. C., Barnhill R. L. Screening for cutaneous melanoma by skin self-examination. J Natl Cancer Inst. 1996 Jan 3;88(1):17–23. doi: 10.1093/jnci/88.1.17. [DOI] [PubMed] [Google Scholar]
  2. Burton R. C., Armstrong B. K. Recent incidence trends imply a nonmetastasizing form of invasive melanoma. Melanoma Res. 1994 Apr;4(2):107–113. doi: 10.1097/00008390-199404000-00005. [DOI] [PubMed] [Google Scholar]
  3. Burton R. C., Coates M. S., Hersey P., Roberts G., Chetty M. P., Chen S., Hayes M. H., Howe C. G., Armstrong B. K. An analysis of a melanoma epidemic. Int J Cancer. 1993 Nov 11;55(5):765–770. doi: 10.1002/ijc.2910550512. [DOI] [PubMed] [Google Scholar]
  4. Cohn-Cedermark G., Månsson-Brahme E., Rutqvist L. E., Larsson O., Johansson H., Ringborg U. Trends in mortality from malignant melanoma in Sweden, 1970-1996. Cancer. 2000 Jul 15;89(2):348–355. doi: 10.1002/1097-0142(20000715)89:2<348::aid-cncr20>3.0.co;2-x. [DOI] [PubMed] [Google Scholar]
  5. Cook M. G., Clarke T. J., Humphreys S., Fletcher A., McLaren K. M., Smith N. P., Stevens A., Theaker J. M., Melia J. The evaluation of diagnostic and prognostic criteria and the terminology of thin cutaneous malignant melanoma by the CRC Melanoma Pathology Panel. Histopathology. 1996 Jun;28(6):497–512. doi: 10.1046/j.1365-2559.1996.d01-464.x. [DOI] [PubMed] [Google Scholar]
  6. Dennis L. K. Analysis of the melanoma epidemic, both apparent and real: data from the 1973 through 1994 surveillance, epidemiology, and end results program registry. Arch Dermatol. 1999 Mar;135(3):275–280. doi: 10.1001/archderm.135.3.275. [DOI] [PubMed] [Google Scholar]
  7. Doherty V. R., MacKie R. M. Experience of a public education programme on early detection of cutaneous malignant melanoma. BMJ. 1988 Aug 6;297(6645):388–391. doi: 10.1136/bmj.297.6645.388. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Edman R. L., Klaus S. N. Is routine screening for melanoma a benign practice? JAMA. 2000 Aug 16;284(7):883–886. doi: 10.1001/jama.284.7.883. [DOI] [PubMed] [Google Scholar]
  9. Giles G. G., Armstrong B. K., Burton R. C., Staples M. P., Thursfield V. J. Has mortality from melanoma stopped rising in Australia? Analysis of trends between 1931 and 1994. BMJ. 1996 May 4;312(7039):1121–1125. doi: 10.1136/bmj.312.7039.1121. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Healsmith M. F., Bourke J. F., Osborne J. E., Graham-Brown R. A. An evaluation of the revised seven-point checklist for the early diagnosis of cutaneous malignant melanoma. Br J Dermatol. 1994 Jan;130(1):48–50. doi: 10.1111/j.1365-2133.1994.tb06881.x. [DOI] [PubMed] [Google Scholar]
  11. Herd R. M., Cooper E. J., Hunter J. A., McLaren K., Chetty U., Watson A. C., Gollock J. Cutaneous malignant melanoma. Publicity, screening clinics and survival--the Edinburgh experience 1982-90. Br J Dermatol. 1995 Apr;132(4):563–570. doi: 10.1111/j.1365-2133.1995.tb08712.x. [DOI] [PubMed] [Google Scholar]
  12. Jackson A., Wilkinson C., Ranger M., Pill R., August P. Can primary prevention or selective screening for melanoma be more precisely targeted through general practice? A prospective study to validate a self administered risk score. BMJ. 1998 Jan 3;316(7124):34–39. doi: 10.1136/bmj.316.7124.34. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. La Vecchia C., Lucchini F., Negri E., Levi F. Recent declines in worldwide mortality from cutaneous melanoma in youth and middle age. Int J Cancer. 1999 Mar 31;81(1):62–66. doi: 10.1002/(sici)1097-0215(19990331)81:1<62::aid-ijc12>3.0.co;2-2. [DOI] [PubMed] [Google Scholar]
  14. Lipsker D. M., Hedelin G., Heid E., Grosshans E. M., Cribier B. J. Striking increase of thin melanomas contrasts with stable incidence of thick melanomas. Arch Dermatol. 1999 Dec;135(12):1451–1456. doi: 10.1001/archderm.135.12.1451. [DOI] [PubMed] [Google Scholar]
  15. Little P., Keefe M., White J. Self screening for risk of melanoma: validity of self mole counting by patients in a single general practice. BMJ. 1995 Apr 8;310(6984):912–916. doi: 10.1136/bmj.310.6984.912. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. MacKie R. M., Hole D. Audit of public education campaign to encourage earlier detection of malignant melanoma. BMJ. 1992 Apr 18;304(6833):1012–1015. doi: 10.1136/bmj.304.6833.1012. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. MacKie R. M., Hole D., Hunter J. A., Rankin R., Evans A., McLaren K., Fallowfield M., Hutcheon A., Morris A. Cutaneous malignant melanoma in Scotland: incidence, survival, and mortality, 1979-94. The Scottish Melanoma Group. BMJ. 1997 Nov 1;315(7116):1117–1121. doi: 10.1136/bmj.315.7116.1117. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Melia J., Cooper E. J., Frost T., Graham-Brown R., Hunter J., Marsden A., Du Vivier A., White J., Whitehead S., Warin A. P. Cancer Research Campaign health education programme to promote the early detection of cutaneous malignant melanoma. I. Work-load and referral patterns. Br J Dermatol. 1995 Mar;132(3):405–413. doi: 10.1111/j.1365-2133.1995.tb08674.x. [DOI] [PubMed] [Google Scholar]
  19. Melia J., Cooper E. J., Frost T., Graham-Brown R., Hunter J., Marsden A., Du Vivier A., White J., Whitehead S., Warin A. P. Cancer Research Campaign health education programme to promote the early detection of cutaneous malignant melanoma. II. Characteristics and incidence of melanoma. Br J Dermatol. 1995 Mar;132(3):414–421. doi: 10.1111/j.1365-2133.1995.tb08675.x. [DOI] [PubMed] [Google Scholar]
  20. Melia J., Ellman R., Chamberlain J. Investigating changes in awareness about cutaneous malignant melanoma in Britain using the Omnibus Survey. Clin Exp Dermatol. 1994 Sep;19(5):375–379. doi: 10.1111/j.1365-2230.1994.tb02685.x. [DOI] [PubMed] [Google Scholar]
  21. Melia J., Harland C., Moss S., Eiser J. R., Pendry L. Feasibility of targeted early detection for melanoma: a population-based screening study. Br J Cancer. 2000 May;82(9):1605–1609. doi: 10.1054/bjoc.2000.1183. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Osborne J. E., Bourke J. F., Holder J., Colloby P., Graham-Brown R. A. The effect of the introduction of a pigmented lesion clinic on the interval between referral by family practitioner and attendance at hospital. Br J Dermatol. 1998 Mar;138(3):418–421. doi: 10.1046/j.1365-2133.1998.02117.x. [DOI] [PubMed] [Google Scholar]
  23. Severi G., Giles G. G., Robertson C., Boyle P., Autier P. Mortality from cutaneous melanoma: evidence for contrasting trends between populations. Br J Cancer. 2000 Jun;82(11):1887–1891. doi: 10.1054/bjoc.1999.1243. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Streetly A., Markowe H. Changing trends in the epidemiology of malignant melanoma: gender differences and their implications for public health. Int J Epidemiol. 1995 Oct;24(5):897–907. doi: 10.1093/ije/24.5.897. [DOI] [PubMed] [Google Scholar]
  25. Tabár L., Fagerberg C. J., Gad A., Baldetorp L., Holmberg L. H., Gröntoft O., Ljungquist U., Lundström B., Månson J. C., Eklund G. Reduction in mortality from breast cancer after mass screening with mammography. Randomised trial from the Breast Cancer Screening Working Group of the Swedish National Board of Health and Welfare. Lancet. 1985 Apr 13;1(8433):829–832. doi: 10.1016/s0140-6736(85)92204-4. [DOI] [PubMed] [Google Scholar]
  26. Whitehead S. M., Wroughton M. A., Elwood J. M., Davison J., Stewart M. Effects of a health education campaign for the earlier diagnosis of melanoma. Br J Cancer. 1989 Sep;60(3):421–425. doi: 10.1038/bjc.1989.298. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Williams H. C., Smith D., du Vivier A. W. Evaluation of public education campaigns in cutaneous melanoma: the King's College Hospital experience. Br J Dermatol. 1990 Jul;123(1):85–92. doi: 10.1111/j.1365-2133.1990.tb01827.x. [DOI] [PubMed] [Google Scholar]
  28. van der Rhee H. J., van der Spek-Keijser L. M., van Westering R., Coebergh J. W. Increase in and stabilization of incidence and mortality of primary cutaneous malignant melanoma in Western Netherlands, 1980-95. Br J Dermatol. 1999 Mar;140(3):463–467. doi: 10.1046/j.1365-2133.1999.02710.x. [DOI] [PubMed] [Google Scholar]

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