PREVENTION AND EARLY DETECTION OF MELANOMA - A SURGEONS PERSPECTIVE

Americans are clearly losing the battle against malignant melanoma. In 1930, it was estimated that one in 1,500 people would develop melanom a, sometime during their lifetimes, but by the year 2000, one in 75 pe ople in the United States will develop the disease. Although the indiv idual case prognosis is improving, the death rate has doubled in the l ast 35 years. The rising mortality rate has to be attributed to an esc alating incidence that is not offset sufficiently by improved diagnosi s and treatment. Malignant melanoma is a disease that lends itself to early detection and screening programs. Melanoma is highly prevalent a nd causes considerable morbidity and mortality. The natural history of the disease is known and it is well established that the earlier diag nosis of ''thinner'' lesions can reduce morbidity and mortality. There is also an acceptable, safe, inexpensive, and noninvasive screening t est for melanoma, the skin examination. This work reviews the current evidence that melanoma screening may be effective, compares screening projects for this cutaneous tumor with other screening programs, and o utlines a proposed project for melanoma screening.