Development of a targeted risk-group model for XXXX screening based on more than 100,000 total skin examinations.

@entity1 @entity320 @entity1489 @entity957 @entity272 @entity6349 @entity1491
BACKGROUND: @entity1489 screening aims to detect potentially metastasizing @entity1489 at an early and surgically curable stage. This may take the form of mass screening, as currently occurs in Germany, or of targeted screening of those at greatest risk. OBJECTIVE: To develop a model to identify @entity1 at high risk of developing @entity1489 who would benefit from regular @entity1489 screening. METHODS: This was an open prospective point-prevalence study of consecutive @entity1 presenting to dermatologists for a total skin check. @entity1489 risk factors were recorded and, for the first time, histology of @entity272 was documented. Results were analysed by univariate and multivariate analyses and, after logistic regression with stepwise forward selection, a risk-group model was developed. RESULTS: The results of 108,281 total skin examinations were available for analysis. 142 definite @entity320 , 108 severely @entity6349 naevi/cannot-exclude- @entity320 , 491 @entity1491 ( @entity1491 ) and 93 @entity957 ( @entity957 ) were excised. A risk model was developed for @entity320 and @entity957 based on mathematical e-functions. The model had >92% sensitivity for @entity320 and @entity957 and an overall 67.24% specificity for @entity320 , @entity957 and @entity1491 . This targeted risk model identified one-third of the study population as being at risk for the development of @entity320 and @entity957 . CONCLUSIONS: Using the risk calculator developed from this study, targeted screening of the identified at-risk population reduces the numbers needed to be screened regularly by 50%, yet has better sensitivity for @entity320 and similar sensitivity for @entity957 compared to the current mass screening programme in Germany.
