Starting in 1999, the provincial health authorities of the Belgian province of Limburg, together with regional health care workers and the funding organization TOKAP, adopted a comprehensive approach towards the population in order to prevent and detect melanomas early. The approach selleck bio included sun protection information campaigns aimed at the population at large as well as at elective target groups, and yearly invitations for screening, within the framework of the Euromelanoma day. Information campaigns can only be expected to show results after decennia, unless the campaign also includes guidelines for self-examination of the skin and screening by physicians, which is the case here.

Yearly screening of the total population, including self-examination of the skin can be ex-pected to result in a higher incidence during a period of two years (first round effect), followed by a gradual decrease towards the original level. As a total population screening is unrealistic, the initial increase will be spread over a much longer period, maybe ten years or more and the incidence peak will be much lower and therefore difficult to detect. Even in this case, however, it can be expected that melanomas will be detected earlier, resulting in the detection of tumours of an earlier stage. After ten years of campaigning, we used data of the Limburg Cancer Registry (LIKAR) [3] as well as a more detailed additional registration of melanomas to evaluate the time trend of both the incidence and the distribution of the stages over the years and tried to relate this to the screening and prevention campaigns.

Methods Design We used a time trend analysis, comparing yearly incidence figures and tumour stages of me-lanomas diagnosed Anacetrapib between 1996 and 2005. Population Our data relate to the population of the Belgian province of Limburg, situated in the north-east of Belgium. The territory covers 2422 km2 or 7.9 % of the Belgian territory. On 1 January 2001 the population totalled 791,178, of which 395,579 men and 395,599 women. The degree of urbanisation is restricted: of the two largest cities Hasselt (n= 68,058 on 01/01/2001) and Genk (n= 62,842 on 01/01/2001) constitute 17% of the total population. Both are situated in the area of Central Limburg. Forty-four percent of the population lives in 32 municipalities with 20,000 inhabitants or less, and 39% in 10 municipalities with 20,000 to 40,000 inhabitants (Figure (Figure11). Figure 1 The distribution of the population. Interventions The intervention was designed and operationalised by a multidisciplinary group including physicians, funders, and policy makers.