A recent study investigating the effectiveness of a skin cancer screening programme in Germany has found no evidence that the initiative reduced melanoma mortality compared with neighbouring countries without population-based screening.

Introduced in 2008, the German skin cancer screening programme entitled men and women aged 35 years and over to a visual whole-body skin examination every two years, irrespective of individual skin cancer risk. The estimated two-year participation rate was approximately 32%.

The recent study, published in the journal JAMA Dermatology, aimed to determine whether the programme was associated with reduced melanoma mortality by analysing official cause-of-death data between 2009 and 2022 from 15 German federal states. Schleswig-Holstein was excluded due to the potential lasting effects of an earlier pilot screening project.

Mortality trends were compared with those of nine neighbouring countries without population-based skin cancer screening programmes: Austria, Belgium, Czechia, Denmark, France, Luxembourg, Netherlands, Poland and Switzerland. The analysis encompassed populations averaging 79.1 million people in Germany and 164.8 million across the comparator countries.

Population screening and mortality rates

Age-standardised melanoma mortality rates declined across all included regions during the study period. In Germany, annual percentage changes (APCs) ranged from −3.8% to −0.1%, while in neighbouring countries APCs ranged from −3.8% to −1.0%.

Pooled analyses showed melanoma mortality decreased by −1.8% annually (95% CI −2.3% to −1.4%) in Germany and by −2.2% annually (95% CI −2.8% to −1.6%) in neighbouring countries. The difference between groups was not statistically significant (P=.42).

Subgroup analyses for 2009-13 and 2013-22 similarly revealed no meaningful differences between Germany and comparator countries.

The authors noted several limitations, including the fact that the study’s ecological design could not evaluate screening effects at an individual level and was therefore susceptible to ecological fallacy. The relatively low participation rate may also have reduced the likelihood of detecting population-level benefits, while opportunistic screening initiatives in comparator countries and evolving use of effective systemic melanoma therapies may have influenced mortality trends.

Nevertheless, the findings were found to be consistent with previous studies that failed to demonstrate a melanoma mortality benefit from the German screening programme.

The authors suggested that future research should focus on identifying the reasons for the programme’s poor performance using robust individual-level data. Ongoing investigations into non-melanoma skin cancer mortality, treatment intensity and healthcare costs may also help to inform decisions regarding the future of routine population-based screening.

Any potential benefits should be balanced against risks such as overdiagnosis, overtreatment, false-positive findings and resource utilisation, the authors concluded, highlighting risk-adapted screening strategies as a potential alternative approach.

UK melanoma diagnoses reach record high

The number of people diagnosed with melanoma in the UK has risen above 20,000 a year for the first time, according to new analysis from the charity Cancer Research UK (CRUK).

The data show that a record 20,980 new melanoma cases were diagnosed across the UK in 2022 and the charity warns that the figure could rise to 26,500 cases a year by 2040.

This projected increase would represent a 23% rise in cases among men and a 26% increase among women over the next 15 years, CRUK said. However, there is hope that this trend can be reversed.

Melanoma is the most serious form of skin cancer and nearly nine in 10 melanoma cases are linked to exposure to ultraviolet radiation from the sun and sunbeds.

Women are more likely than men to be diagnosed with melanoma at younger ages, while rates are higher among men later in life, according to the analysis.

CRUK said higher rates in younger women were likely linked to sunbathing and sunbed use, while long-term sun exposure could contribute to higher rates among older men.

In February, the Government announced plans to eliminate underage sunbed use in a bid to reduce melanoma skin cancer risks in teenagers.

Michelle Mitchell, chief executive of CRUK, said she was concerned about the rising number of melanoma skin cancer diagnosis in the UK, adding that the fact ‘most of these cases are preventable underlines the importance of people taking sun safety seriously’.

The charity also acknowledged that rising case numbers partly reflects the UK’s ageing population and greater awareness of melanoma, which may be contributing to increased diagnosis rates.

Reference
Hübner J et al. Population Skin Cancer Screening and Melanoma Mortality Rates. JAMA Dermatol 2026; doi:10.1001/jamadermatol.2026.1527.