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May 9, 1986

Screening for Melanoma and Skin Cancer

JAMA. 1986;255(18):2443-2444. doi:10.1001/jama.1986.03370180069016

To the Editor.—  A recent critique of screening procedures at health fairs by Donald M. Berwick, MD,1 in the Sept 20, 1985, issue has been interpreted by the lay press as a negative review of health fairs (Chicago Sun-Times, Sept 20, 1985). It would be unfortunate to have negative reviews overshadow effective and efficient screening programs. Screening for hypertension and colorectal cancer was found by Berwick to be "soundly linked with a plausible chain of events leading from early detection to improved health." The criteria for screening to be effective and efficient were met, at least in part, by blood pressure and fecal occult blood testing.Screening for melanoma and skin cancer, although not reviewed by Berwick, also meets his criteria, which are as follows: (1) The disease must be widespread and unlikely to be detected without screening. (2) Screening must have a low error rate and be low