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Melanoma overdiagnosis: What do we know and what do we do?
Simon Clark1, Nikita Rosendahl2, Cliff Rosendahl3
1MBChB, FRCPA, Senior Lecturer, Faculty of Medicine, The University of Queensland, Brisbane, Qld; Distinguished Visiting Professor TUMS, Department of Dermatology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Background:
Melanoma overdiagnosis occurs when melanomas, not destined to cause morbidity or death in a patient's lifetime, are identified and treated.
Objective:
This study considers the causes and magnitude of melanoma overdiagnosis in Australia. We also speculate about a possible benefit of overdiagnosis in Australia; namely, a reduction in excess deaths in the geographical areas where melanoma is diagnosed most frequently.
Discussion:
Overdiagnosis can arguably be mitigated by factors that reduce the number of lesions treated for each melanoma identified. Data from the Australian Cancer Atlas show that there is a reduction in excess deaths from melanoma in geographical areas where diagnostic rates are higher (Pearson correlation coefficient r=-0.5978, 95% CI: -0.6243 to -0.5699, P<0.0001); this being the strongest inverse correlation observed among the 20 cancer types in the Atlas. Is early diagnosis of actual life-threatening melanomas in these geographical regions impacting survival? Further research is planned.
