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SUMMARY
Much has been written about the epidemic of melanoma in the United States and
elsewhere in the world. Often debate has centered on the causes and
consequences of recent epidemiological trends and even whether there truly has
been an epidemic. Skin screening examinations by visual inspection are thought
by many to be a reasonably simple, minimally invasive means by which
melanoma morbidity and mortality could be reduced. However, some actually
see increased melanoma screening as one of the causes of an apparent, though
not real epidemic. Surprisingly few studies on effectiveness or cost-effectiveness
of melanoma screening are available to guide policy makers on decisions
regarding screening and thus there is little consensus among various groups
regarding recommendations for such screening. This dissertation’s main goal
was to estimate the effectiveness and cost-effectiveness of melanoma screening
from the best available data.
The effectiveness and cost-effectiveness of melanoma screening were estimated
using a decision analysis model. The reference case model represented
outpatient screening for melanoma using visual inspection of the skin by
dermatologists in 1998 in a self-selected, higher-than-average-risk population by
incorporating data from the American Academy of Dermatology (AAD)
screenings and the National Cancer Institute’s Surveillance and Epidemiology
