New research suggests a UK-wide screening programme for melanoma could be cost-effective. The authors of the study say current evidence is highly uncertain but suggest such a programme is potentially cost-effective using the Williams self-assessment tool.
They suggest that all those with a Williams risk score greater than 15 should have a one-off full-body skin examination with a primary care practitioner. Those with a risk score greater than 22 should be enrolled into a primary care-based monitoring programme with a 5-year recall, and those with a score greater than 43 would have annual monitoring.
However, the study also suggests that the cost of implementing the programme in the United Kingdom would be high and would involve inviting an estimated 61% of the adult population to at least one examination. The initiative would cost an extra £4.9 billion for 30 years or approximately £164 million per year (0.1% of the 2016 NHS budget).
This would, however, yield approximately 15,947 additional quality-adjusted life years (QALYs) per year. The incremental cost per QALY was estimated at £10,199, well below the accepted threshold of £20,000-£30,000/QALY. In comparison, the incremental cost for the breast screening is £20,800/QALY gained.
Because of the scale of the programme and the costs involved, a phased implementation targeting only the highest risk groups may be practical, the authors say; however, they added that this must be embedded within a rigorous randomised trial to reduce uncertainty decision and inform further rollout.
