JAMA Dermatology Authors Seek Policy Change in Melanoma Screening in US

Writers in the recent issue of JAMA Dermatology call on the healthcare system to change the way the nation screens for melanoma, citing the $291 million annual cost of treating the disease and the $2.85 billion costs in lost productivity, which authors say could be trimmed if cases were caught earlier.

“The considerable economic burden of melanoma should call attention to this disease as a national health care priority,” say Marilyn R. Wickenheiser, BS, Jeremy S. Bordeaux, MD, MPH, and June K. Robinson, MD, writing in the Sept. 3 issue of JAMA Dermatology, a publication of the Journal of the American Medical Association. Only about 60 percent of primary care physicians screen for skin cancer during checkups, with 43 percent citing lack of reimbursement as a reason. Others reasons cited include lack of training in identifying melanoma, as well as uncertainty over how old patients should be when screening begins.

Data show that among men, most cases of melanoma occur after age 50, but 10 percent of new cases from 2006 to 2010 occurred in patients ages 35 to 44 years old. Among women, the authors say, incidence is higher among the 15-to-49 age group, which they attribute to higher use of tanning beds among young women.

Their call to arms comes on the heels of the warning from Acting U.S. Surgeon General Boris Lusniak, who on July 31, 2014, told Americans that tanned skin is damaged skin. “We must act with urgency to stop the ever-increasing incidence of skin cancers in the United States,” he said, citing rising numbers of skins cancer cases over the past three decades. The number of American with skin cancer over the past three decades is higher than the total for all other cancers combined — and rates are climbing in recent years, Lushniak warned.

Nearly 9,000 Americans die each year of melanoma, the deadliest form of skin cancer—and it’s become one of the most common forms of cancer in young people.

The JAMA Dermatology article outlines a pilot project in Germany in which primary care physicians received training and reimbursement to screen for melanoma and refer patients with suspicious lesions to dermatologists for follow-up care. Mortality rates from melanoma declined after the program was implemented.

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