Is screening for melanoma in average risk subjects beneficial

摘要

Routine skin examination, either conducted by a doctor or by self-screening, is widely practised in Australia, although authoritative groups and clinical guidelines do not recommend screening. This inconsistency is due to the very limited information from studies with the ability to assess the value of screening. There are no randomised trials of the effects of screening for melanoma on end points like mortality. As a consequence, we have no rigorous evidence to show or disprove the value of routine skin cancer screening. Partial body self-screening is particularly prevalent, and whole-body screening and screening by a doctor are also commonly done. This high level of screening activity results in greater intervention. This may be beneficial; but there are also concerns that substantial numbers of non-progressive lesions are being detected and removed. These and other issues are explored.