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The impossibility of mortality evaluation of skin cancer screening in Germany based on health insurance data: a case-control study
Journal article   Peer reviewed

The impossibility of mortality evaluation of skin cancer screening in Germany based on health insurance data: a case-control study

Andreas Stang, Katrin Schuldt, Pietro Trocchi, Silke Neusser, Christian Speckemeier, Kathrin Pahmeier, Juergen Wasem, Hildegard Lax and Michael Nonnemacher
European journal of cancer (1990), v 173, pp 52-58
01 Sep 2022
PMID: 35863106

Abstract

Life Sciences & Biomedicine Oncology Science & Technology
Background: The aim of this paper was to perform a mortality evaluation of skin cancer screening (SCS) in Germany using General Local Health Insurance Fund (AOK) data. Methods: AOK-insured men and women aged 35-99 years who died of cutaneous malignant melanoma in 2015-2016 were identified. Controls were AOK-insured people who survived to the end of each case's year of death. For each case, 10 controls were matched. The SCS history of each individual was reconstructed using the billing codes 01745 and 01746. Results: In total, 1037 melanoma deaths and 10,370 controls were included. Cumulative SCS prevalence increased among controls over calendar years, as expected (males and females, 2009: 13.5% and 12.5%; 2015: 52.1% and 55.1%). In contrast, among cases, cumulative SCS prevalence was already high in 2009 and did not show a monotonic increase over the years of diagnosis. Of the 1037 melanoma deaths, 224 (21.6%) had at least one SCS settled in the 12 months after diagnosis. Discussion: A mortality evaluation with health insurance data alone is not possible because SCS billing codes are not only used for real SCS but also for occasion-related diagnostic work-up of abnormal skin findings. A mortality evaluation with health insurance data requires an individual linking with data of the screening physician and the cancer registries. (C) 2022 Elsevier Ltd. All rights reserved.

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