[Screening for and early detection of skin melanoma in the Netherlands]

During the past few decades, the incidence of skin melanoma has increased greatly in the Netherlands. At the same time, the mortality from skin melanoma has increased, especially amongst older men. Because of the strong association between disease stage and prognosis, screening and an increase in awareness would appear to be good strategies for early detection of skin melanoma, thus reducing the disease burden. At the moment there is no conclusive evidence that mass screening of the population will decrease morbidity and mortality due to skin melanoma. In addition, there is uncertainty about the cost-effectiveness and about the organization of mass screening. In theory, screening of high-risk populations based on risk factors should be more efficient, but it is unclear how this selection should be carried out. Results of a mass screening project currently underway in Germany will provide more clarity on this subject. Until then, educating the general population and general practitioners about recognition of skin melanoma is of major importance in achieving early detection.