VOLUNTEER MELANOMA SCREENINGS - FOLLOW-UP, COMPLIANCE, AND OUTCOME

BACKGROUND. Follow-up information on free melanoma screening clinics i s not readily available. OBJECTIVE AND METHODS. We studied the follow- up, compliance, and outcome of positive screenees after a screening ca mpaign for melanoma in the Netherlands. RESULTS. Of the 4146 participa nts, 486 (11.7%) had a suspicious premalignant or malignant lesion war ranting referral to his or her general physician indicating the propos ed line of management. Participants with borderline lesions were not r eferred. Referral of borderline cases should have resulted in a consid erable increase of the number of positive screenees (18.1%). All posit ive screenees but two gave permission for follow-up. Only 18 screenees (3.7%) were lost during follow-up. Moreover, one screenee with a pres umed basal cell carcinoma and six screenees suspicions of having a pre malignant lesion decided not to seek medical attention despite several reminders. The positive predictive value for melanoma was 17.2%, and for nonmelanoma skin cancers was 42.9%. CONCLUSION. A selective referr al policy may reduce the generated costs of melanoma screenings substa ntially Adequate follow-up of positive screenees is mandatory in order to determine the ultimate yield and usefulness of such campaigns. (C) 1997 by the American Society for Dermatologic Surgery, Inc.