{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T06:10:34Z","timestamp":1793340634310,"version":"4.5.0"},"reference-count":20,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2015,8,26]]},"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>In 2003, a skin cancer screening campaign based on total body skin examination was launched in the federal state of Schleswig-Holstein, Germany. 20% of adults aged 20 and over were screened. In 2008, a 48% decline in melanoma mortality was reported. In the same year, skin screening was extended to the rest of Germany. We evaluated whether melanoma mortality trends decreased in Germany as compared with surrounding countries where skin screening is uncommon. We also evaluated whether the initial decreasing mortality trend observed in Schleswig-Holstein was maintained with a longer follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting and participants<\/jats:title>\n                    <jats:p>Regional and national melanoma mortality data from 1995 to 2013 were extracted from the GEKID database and the Federal Statistical Office. Mortality data for Germany and surrounding countries from 1980 to 2012 were extracted from the WHO mortality database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Age-adjusted (European Standard Population) mortality rates were computed and joinpoint analysis performed for Schleswig-Holstein, Germany and surrounding countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In Schleswig-Holstein, melanoma mortality rates declined by 48% from 2003 to 2008, and from 2009 to 2013 returned to levels observed before screening initiation. During the 5\u2005years of the national programme (2008\u20132012), melanoma mortality rates increased by 2.6% (95% CI \u22120.1 to 5.2) in men and 0.02% (95% CI \u22121.8 to 1.8) in women. No inflexion point in trends was identified after 2008 that could have suggested a decreasing melanoma mortality. Trends of cutaneous melanoma mortality in Germany from 1980 to 2012 did not differ from those observed in surrounding countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The transient decrease mortality in Schleswig-Holstein followed by return to pre-screening levels could reflect a temporal modification in the reporting of death causes. An in-depth evaluation of the screening programme is required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2015-008158","type":"journal-article","created":{"date-parts":[[2015,9,15]],"date-time":"2015-09-15T21:20:18Z","timestamp":1442352018000},"page":"e008158","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":95,"title":["Melanoma mortality following skin cancer screening in Germany"],"prefix":"10.1136","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1052-5604","authenticated-orcid":false,"given":"Mathieu","family":"Boniol","sequence":"first","affiliation":[{"name":"University of Strathclyde Institute of Global Public Health at iPRI, International Prevention Research Institute, Lyon, France"},{"name":"International Prevention Research Institute (iPRI), Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Autier","sequence":"additional","affiliation":[{"name":"University of Strathclyde Institute of Global Public Health at iPRI, International Prevention Research Institute, Lyon, France"},{"name":"International Prevention Research Institute (iPRI), Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Gandini","sequence":"additional","affiliation":[{"name":"European Institute of Oncology, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2015,9,15]]},"reference":[{"key":"2025120617535708000_5.9.e008158.1","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.ypmed.2014.01.003","article-title":"Total body skin examination for skin cancer screening among US adults from 2000 to 2010","volume":"61","author":"Lakhani","year":"2014","journal-title":"Prev Med"},{"key":"2025120617535708000_5.9.e008158.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2010.11.016"},{"key":"2025120617535708000_5.9.e008158.3","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2012.22"},{"key":"2025120617535708000_5.9.e008158.4","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/cku047"},{"key":"2025120617535708000_5.9.e008158.5","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.27566"},{"key":"2025120617535708000_5.9.e008158.6","doi-asserted-by":"crossref","first-page":"611.e1","DOI":"10.1016\/j.jaad.2014.05.045","article-title":"Screening, early detection, education, and trends for melanoma: current status (2007\u20132013) and future directions: Part II. Screening, education, and future directions","volume":"71","author":"Mayer","year":"2014","journal-title":"J Am Acad Dermatol"},{"key":"2025120617535708000_5.9.e008158.7","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/j.canep.2010.03.006","article-title":"A nationwide population-based skin cancer screening in Germany: proceedings of the first meeting of the International Task Force on Skin Cancer Screening and Prevention (September 24 and 25, 2009)","volume":"34","author":"Geller","year":"2010","journal-title":"Cancer Epidemiol"},{"key":"2025120617535708000_5.9.e008158.8","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X14543106"},{"key":"2025120617535708000_5.9.e008158.9","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1159\/000342374","article-title":"Routine skin cancer screening in Germany: four years of experience from the dermatologists\u2019 perspective","volume":"225","author":"Kornek","year":"2012","journal-title":"Dermatology"},{"key":"2025120617535708000_5.9.e008158.10","unstructured":"Gesellschaft der epidemiologischen Krebsregister in Deutschland e.V. 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Washington DC: US Dept of Health and Human Services, Office of the Surgeon General, 2014. http:\/\/www.surgeongeneral.gov\/library\/calls\/prevent-skin-cancer\/ (accessed 15 Dec 2014)."},{"key":"2025120617535708000_5.9.e008158.18","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-11-129"},{"key":"2025120617535708000_5.9.e008158.19","doi-asserted-by":"publisher","DOI":"10.1163\/157180905774857916"},{"key":"2025120617535708000_5.9.e008158.20","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)06449-2"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2015-008158","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T01:54:05Z","timestamp":1765072445000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2015-008158"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,9]]},"references-count":20,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2015,9,15]]},"published-print":{"date-parts":[[2015,9]]}},"alternative-id":["10.1136\/bmjopen-2015-008158"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2015-008158","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,9]]}}}