Over 50% of all melanoma diagnoses among White patients in the United States may in fact be overdiagnoses, according to a recent study published by Adamson et al in BMJ Evidence-Based Medicine.
Background
“Cases of cutaneous melanoma have risen significantly in the [United States] over the last 40 years without an equivalent rise in mortality—which points to overdiagnosis,” emphasized lead study author Ade Adamson, MD, MPP, Assistant Professor in the Department of Internal Medicine at the Dell Medical School at The University of Texas at Austin. “Overdiagnosis happens when melanoma is diagnosed that is actually harmless. That means the patient may undergo expensive, unnecessary treatments that may do far more harm than good,” he added.
Study Methods and Results
In the recent study, investigators found that approximately 49.7% of melanoma diagnoses among White male patients and 64.6% of diagnoses among White female patients were cases of overdiagnosis in 2018—totaling 83,000 cases of melanoma. After analyzing national data, the investigators discovered that the lifetime risk of being overdiagnosed with melanoma increased from 1975 to 2018.
Additionally, a large proportion of the overdiagnoses were stage 0 melanoma. The investigators estimated that 89% and 85% of these melanoma cases may be overdiagnosed in White male and female patients in the United States, respectively.
Conclusions
“This study shouldn’t dissuade [individuals] from getting concerning moles evaluated for melanoma, especially if you are high risk,” underscored Dr. Adamson. “However, my hope is that it informs how [patients] receive a melanoma diagnosis and brings awareness to the phenomenon of overdiagnosis [as] an unintended consequence of screening,” he concluded.
Disclosure: For full disclosures of the study authors, visit ebm.bmj.com.
