背景：本文的目的是使用普通地方健康保险基金（AOK）数据对德国的皮肤癌筛查（SCS）进行死亡率评估。
方法：确定了2015-2016年因皮肤恶性黑色素瘤死亡的35-99岁的AOK保险男性和女性。对照组是AOK保险的人，他们存活到每个病例的死亡年份。对于每种情况，匹配10个对照。使用计费代码01745和01746重建每个人的SCS历史。
结果：总计，包括1037例黑色素瘤死亡和10,370例对照。累积SCS患病率在各日历年的对照组中增加，如预期的那样(男性和女性，2009年：13.5%和12.5%；2015年：52.1%和55.1%）。相比之下,在案件中，2009年SCS的累积患病率已经很高,并且在诊断后的几年中没有显示单调增加.在1037例黑色素瘤死亡中，224（21.6％）在诊断后的12个月内至少有一个SCS定居。
结论：仅使用健康保险数据进行死亡率评估是不可能的，因为SCS计费代码不仅用于真实的SCS，还用于与场合相关的异常皮肤发现的诊断工作。使用健康保险数据进行死亡率评估需要个人与筛查医生和癌症登记处的数据联系起来。
BACKGROUND: The aim of this paper was to perform a mortality evaluation of skin cancer screening (SCS) in Germany using General Local Health Insurance Fund (AOK) data.
METHODS: AOK-insured men and women aged 35-99 years who died of cutaneous malignant melanoma in 2015-2016 were identified. Controls were AOK-insured people who survived to the end of each
case\'s year of death. For each
case, 10 controls were matched. The SCS history of each individual was reconstructed using the billing codes 01745 and 01746.
RESULTS: In total, 1037 melanoma deaths and 10,370 controls were included. Cumulative SCS prevalence increased among controls over calendar years, as expected (males and females, 2009: 13.5% and 12.5%; 2015: 52.1% and 55.1%). In contrast, among cases, cumulative SCS prevalence was already high in 2009 and did not show a monotonic increase over the years of diagnosis. Of the 1037 melanoma deaths, 224 (21.6%) had at least one SCS settled in the 12 months after diagnosis.
CONCLUSIONS: A mortality evaluation with health insurance data alone is not possible because SCS billing codes are not only used for real SCS but also for occasion-related diagnostic work-up of abnormal skin findings. A mortality evaluation with health insurance data requires an individual linking with data of the screening physician and the cancer registries.
