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Pharmacologic Induction of Epidermal Melanin and Protection Against Sunburn in a Humanized Mouse Model
Published on: September 7, 2013
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Ecological study estimating melanoma overdiagnosis in the USA using the lifetime risk method
Adewole S Adamson1, Geetanjali Naik2, Mark A Jones3
1Department of Internal Medicine (Division of Dermatology), Dell Medical School at The University of Texas at Austin, Austin, Texas, USA adewole.adamson@austin.utexas.edu.
BMJ Evidence-Based Medicine
|January 19, 2024
Summary
Overdiagnosis of melanoma is a significant concern in the USA, with nearly half of melanoma diagnoses in men and over half in women potentially being overdiagnosed. This trend is increasing, particularly for in situ melanomas.
Area of Science:
- Dermatology
- Oncology
- Epidemiology
Background:
- Melanoma incidence has been rising in the United States.
- Understanding the extent of overdiagnosis is crucial for effective public health strategies and resource allocation.
- Previous estimates of melanoma overdiagnosis have varied, necessitating updated quantification.
Purpose of the Study:
- To quantify the proportion of melanoma diagnoses (invasive and in situ) in the USA that may be overdiagnosed.
- To analyze trends in melanoma overdiagnosis among white American men and women from 1975 to 2018.
Main Methods:
- Ecological study utilizing Surveillance, Epidemiology, and End Results (SEER 9) registry data.
- DevCan software used to calculate cumulative lifetime risk of melanoma diagnosis, adjusted for longevity and risk factor changes.
- Analysis focused on white American men and women from 1975-2018, with overdiagnosis inferred from excess lifetime risk.
Main Results:
- Adjusted lifetime risk of melanoma diagnosis increased significantly from 1975-2018 for both white men and women.
- Melanoma in situ diagnoses saw a dramatic rise, increasing from 0.17% to 2.7% in men and 0.08% to 2.0% in women.
- In 2018, an estimated 49.7% of melanomas in white men and 64.6% in white women were overdiagnosed; 85-89% of in situ melanomas were likely overdiagnosed.
Conclusions:
- Melanoma overdiagnosis in white Americans is substantial and increasing over time.
- In 2018, an estimated 44,000 men and 39,000 women were overdiagnosed with melanoma.
- A high proportion of overdiagnosed melanomas are in situ, suggesting this subtype as a key area for intervention.
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