Study: Skin cancer screening in Germany shows no measurable survival benefit

The researchers compared the development of melanoma mortality in Germany with that in nine neighboring countries that do not have a comparable program. For Germany, figures from 15 federal states were used. In the observation period from 2009 to 2022, all countries studied showed a decline in mortality, averaging around two percent per year. "Diese Ergebnisse stehen im Einklang mit früheren Studien, die keinen Vorteil hinsichtlich der Melanomsterblichkeit durch das derzeitige deutsche Hautkrebs-Screening-Programm nachweisen konnten", Hübner and his co-authors wrote in "JAMA Dermatology".

International comparison shows no advantage for Germany

In the direct group comparison, the decline in Germany was even somewhat weaker at minus 1.8 percent annually than in the neighboring countries. "Diese Erwartung bestätigte sich nicht", the authors summarized their central observation. As a result, their conclusion stated, the hoped-for benefit of screening at the population level has so far not been demonstrated.

The study thus also raises anew the question of the value of established early detection programs. "Der Nutzen ist seit Jahren umstritten", according to a press release accompanying the work. Involved alongside the Epidemiological Cancer Registry of Lower Saxony were also researchers from the University of Lübeck. The results were published under the DOI 10.1001/jamadermatol.2026.1527.

Low participation as a possible explanation

Another finding concerns the actual uptake of screening. According to official figures, only between 6.4 and 9.2 percent of eligible insured persons in Germany took part in skin cancer screening at a general practice and 6.2 to 7 percent in screening at a dermatology practice during the 2019 to 2022 period. The low participation rate is considered one possible reason why a population-wide effect is difficult to demonstrate.

Focus on risk groups as a possible new strategy

Against this backdrop, the researchers discuss possible adjustments. "Überlegt wird eventuell eine Konzentration auf besondere Risikogruppen, um die sogenannte 'Vortestwahrscheinlichkeit' zu erhöhen und damit mehr Gefährdete in die Gruppe der Untersuchten zu bekommen", according to the statement. The aim is for the examination to more specifically reach those people in the future who have an elevated risk of melanoma.

Looking at other types of cancer

While the early detection of skin cancer is under discussion, other data point to potential in other types of tumors. For example, the five-year survival rate for lung cancer detected early is up to 90 percent. In Austria, lung cancer screening has long been called for, which according to estimates could prevent up to 45 percent of the approximately 4,000 deaths annually. The discussion about meaningful early detection is thus gaining importance beyond the topic of skin cancer.

Overall, the study paints a sober picture: the previous form of skin cancer screening in Germany has not lived up to the great hopes. Whether a stronger focus on risk groups can improve effectiveness must be shown by future analyses. Until then, the program formally remains in place, but its justification is under scrutiny.