Access to statutory skin cancer screening:Organizational and regional factors in Germany,Zugang zum gesetzlichen Hautkrebsscreening. Organisatorische und regionale Faktoren in Deutschland

BACKGROUND: In 2008, statutory skin cancer screening (gesetzliches Hautkrebsscreening, gHKS), conducted by dermatologists or general practitioners, was introduced in Germany. The aim was earlier detection of cancer and therefore improved health care delivery. To assess the success of the gHKS and to increase utilization, the opinion of the population on access to the gHKS is of great relevance.

OBJECTIVES: The study examines administrative and regional factors of access to the gHKS in Germany.

MATERIALS AND METHODS: In this cross-sectional study, a nationwide survey was conducted among statutory health insured persons aged 18 and over. They were interviewed by telephone about the gHKS with focus on the access to the gHKS. Descriptive statistics and subgroup analysis based on sociodemographic variables and physician specialties were performed.

RESULTS: Overall, 1015 people were interviewed, of whom 359 (35.4%) had already utilized the gHKS. Most of them (38.3%) were informed about this service by their general practitioner. Most respondents (70%) preferred having the dermatologists conduct the screening and more participants consulted the dermatologist than the general practitioner for it (76% vs. 24%). At the dermatologist, the travel time to the gHKS was more often longer than 30 min (12% vs. 1%, p < 0.05) and the waiting times for appointments were more often longer than 2 weeks (67% vs. 18%, p < 0.05). Regional differences were identified for travel times and the choice of travel modalities.

CONCLUSIONS: The participants of the study preferred having a dermatologist conduct the gHKS. The dermatologist was also consulted more frequently by the gHKS participants. However, access in terms of travel and waiting times for the gHKS was longer at the dermatologist than at the general practitioner.