The relation between mortality from malignant melanoma and early detectionin the Cancer Research Campaign Mole Watcher Study

Between 1987 and 1989 the Cancer Research Campaign funded a health educatio n programme for the early detection of cutaneous malignant melanoma in the general population in 6 health districts of England and I health board in S cotland (population of 3 million). The intervention was evaluated by studyi ng its effects on annual and cumulative mortality rates for melanoma. Popul ation-based data on mortality from melanoma were collected in the intervent ion areas, the health regions covering those areas, and 5 other health regi ons of England from 1981 to 1996. Deaths from melanoma in cases diagnosed a fter the start of the intervention were used to study cumulative mortality rates. The annual mortality rates for melanoma, 1981 to 1996, showed no sig nificant difference in their trends between the intervention areas, and oth er areas of England and Wales, After adjustment for pre-intervention rates, there was also no significant reduction in cumulative mortality from melan oma in the intervention areas compared with the non-intervention areas: rat e ratio 1.2 (95% CI 0.9-1.7) in men, 0.9 (95% CI 0.7-1.3) in females. The l ack of a significant reduction in melanoma mortality associated with the in tervention raises questions about this approach to early detection and emph asises the need for new strategies. (C) 2001 Cancer Research Campaign.