Forum for Nordic Dermato-Venereology Nr1,2019 | Page 18

Petter Gjersvik, Jon Langeland, Mona Stensrud and Ingrid Roscher – Four years of Euromelanoma skin cancer awareness campaign in
Norway 2014–2017
clinically suspicious lesions, which for melanoma ranged from
1.1% to 19.4% (5). In Norway, as in Sweden (4), the number
of diagnosed keratinocyte skin cancers was higher than for
melanoma, but these cancer forms, particularly basal cell
carcinomas, have generally a good prognosis.
Our data, as well as anecdotal feedback from dermatologists,
indicate that a substantial proportion of those screened were
not at increased risk of melanoma nor had a truly suspicious
skin lesion, mirroring reported challenges of similar campaigns
in other countries (1, 4).
any change in colour, size and/or shape of an existing mole,
should be highlighted. An annual campaign, with or without
organised skin examinations, to attract attention from mass
media and the general public is an excellent opportunity for
dermatologists to promote this message.
R eferences
1. Stratigos AJ, Forsea AM, van der Leest RJ, de Vries E, Nagore E,
Bulliard JL, et al. Euromelanoma: a dermatology-led European cam-
paign against nonmelanoma skin cancer and cutaneous melanoma.
Past, present and future. Br J Dermatol 2012; 167 (Suppl 2): 99–104.
Mass screening for detecting cutaneous melanoma is not
recommended, as the evidence of any significant effect on
mortality is lacking (6). Randomized control trials of the
effect of screening for melanoma are difficult to set up (7).
Targeted screening of persons with a high risk of melanoma
requires methods to identify and recruit such individuals (6).
Intensified screening efforts may result in overdiagnosis, i.e.
diagnosing lesions that would not have any impact on the
person’s life or life expectancy if it had not been diagnosed
and removed (6, 8). We therefore regard the Euromelanoma
campaign as an awareness campaign supported by skin exami­
nation events, and not as a screening campaign.
2. Forsea AM, del Marmol V, de Vries E, Balley EE, Geller AC. Melano-
ma incidence and mortality in Europe: new estimates, persistent
disparities. Br J Dermatol 2012; 167: 1124–1130.
3. Robsahm TE, Helsing P, Nilssen Y, Vos L, Rizvi SMH, Akslen LA,
et al. High mortality due to cutaneous melanoma in Norway: a
study of prognostic factors in a nationwide cancer registry. Clin
Epidemiol 2018; 10: 537–548.
4. Paoli J, Danielsson M, Wennberg AM. Results of the ‘Euromela-
noma Day’ screening campaign in Sweden 2008. J Eur Acad Derm
Venereol 2009; 23: 1304–1310.
5. van der Leest RJ, de Vries E, Bulliard JL, Paoli J, Peris K, Stratigos
AJ, et al. The Euromelanoma skin cancer prevention campaign in
Europe: characteristics and results of 2009 and 2010. J Eur Acad
Derm Venereol 2011; 25: 1455–1465.
6. Wernli KJ, Henrikson NB, Morrison CC, Nguyen M, Pocobelli G,
We believe that campaigns to prevent melanoma and
other forms of skin cancer should focus more on the need
for more healthy sun habits, particularly avoiding sunburn
and use of sun beds, than on screening. Also, information on
self-examination of pigmented skin lesions and early signs of
melanoma, i.e. the appearance of one pigmented skin lesion
that is different from all others (“the ugly duckling-sign”), and
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D ermato -V enereology in the N ordic C ountries
Blasi PR. Screening for skin cancer in adults: Updated evidence
report and systematic review for the US Preventive Services Task
Force. JAMA 2016; 316: 436–447.
7. Halvorsen JA, Løberg M, Gjersvik P, Roscher I, Veierød MB, Rob-
sahm TE, et al. Why a randomized melanoma screening trial is not
a good idea. Br J Dermatol 2018; 179: 532–533.
8. Weyers W. The ‘epidemic’ of melanoma between under- and over-
diagnosis. J Cutan Pathol 2012; 39: 9–16.
Forum for Nord Derm Ven 2019, Vol. 24, No. 1