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The melanoma epidemic. Is increased surveillance the solution or the problem?
1Department of Dermatology, Emory University School of Medicine, Atlanta, Ga., USA.
Archives of Dermatology
|August 1, 1996
Summary
Early detection of melanoma has improved survival rates, but rising diagnoses may not reflect true disease increase. Aggressive surveillance might be identifying benign tumors, not just malignant melanoma.
Area of Science:
- Dermatology
- Oncology
- Pathology
Background:
- Melanoma historically had a poor prognosis, leading to emphasis on early detection.
- Improved survival rates and increased melanoma diagnoses are observed.
- The rising incidence of melanoma warrants closer examination.
Purpose of the Study:
- To critically evaluate the observed increase in melanoma diagnoses.
- To investigate whether increased diagnoses correlate with actual disease progression or mortality.
- To explore the role of aggressive surveillance in identifying non-malignant pigmented lesions.
Main Methods:
- Analysis of melanoma incidence rates.
- Comparison of diagnostic rates with mortality data.
- Examination of tumor thickness in diagnosed cases.
- Review of diagnostic criteria for pigmented skin lesions.
Main Results:
- Melanoma survival rates have improved significantly.
- There is a marked increase in melanoma diagnoses.
- Mortality rates and diagnoses of thick melanomas (>1.5 mm) have not increased commensurately with overall diagnoses.
- The rise in diagnoses may be partly due to aggressive surveillance identifying benign or low-potential tumors.
Conclusions:
- The increase in melanoma diagnoses may not solely represent an increase in true, aggressive disease.
- Aggressive surveillance may lead to overdiagnosis of indolent or benign pigmented lesions.
- Further investigation is needed to differentiate between true melanoma and benign lesions to avoid overtreatment.