More Than Half of Melanoma Diagnoses in the U.S. Are Unnecessary, Study Finds

Fact checked by Nick Blackmer

Key Takeaways

• Over half of melanoma diagnoses in White Americans may be unnecessary.

• Increased melanoma awareness has led to more screenings and biopsies, not necessarily a reduction in death rates.

• Treating all early-stage melanomas equally may result in no benefit but rather cause potential harm to patients.
  

Catching cancer early can improve treatment outcomes significantly. However, a recent study suggests that over half of the melanoma diagnoses in the United States may be unnecessary.

The study was limited to White Americans, who are more prone to melanoma than other groups. Researchers found that 65% of White women and 50% of White men were overdiagnosed. These cases may not have posed a genuine threat to their health.

“We are increasingly calling harmless moles melanoma when, in fact, they never would progress and develop into aggressive cancers that harm people,” said Adewole Adamson, MD, MPP, a board-certified dermatologist and a co-author of the study.

Being diagnosed with melanoma could lead patients to believe that they’re stuck with a lifetime diagnosis. “A patient diagnosed with Stage 0 melanoma is told that they have cancer, which causes a lot of anxiety,” Adamson said.

The overdiagnoses may be explained by an increase in public awareness of melanoma, according to Christopher Chu, MD, a board-certified dermatologist and dermatopathologist based in Austin, Texas.

“More patients are getting screened, and more moles are being biopsied,” he said.

Related: What Are the Different Types of Skin Cancer?

Unnecessary Treatments ‘Derive No Benefit’

So far, research hasn’t proven that finding more early-stage melanomas can lower the number of advanced or thicker melanomas or reduce death rates, Chu explained. If catching these early melanomas were truly preventing them from becoming more serious, there should be fewer cases of advanced melanomas as a result. But this hasn’t been the case.

Related: Breslow Thickness of a Melanoma

Early-stage, thin lesions are often diagnosed as cancerous because of lower diagnostic thresholds and a lack of conclusive, standardized diagnostic tools. Chu said there’s no clear method to predict how thin melanomas will behave, so providers rely on certain unusual characteristics—such as appearance—as indicators of potential issues.

“So unfortunately, the answer to the question ‘is it bad or is it preventative?’ is not clear,” he said.

Adamson added that while a vast majority of stage 0 melanomas do not progress into late-stage cancer, doctors can’t be sure which ones will progress, so they tend to treat them all. Patients will have to deal with the stress of surgical removal procedures and repeat skin exams.

“Most patients derive no benefit and only harm because there is nothing to fix,” he said. “They are labeled with cancer and recommended to see a dermatologist at least yearly for life.”

Related: How Melanoma vs. Sunspots Look on Skin

A Shift in Mindset Might Help

These overdiagnoses also add strain to the healthcare system as more patients seek biopsies and repeat exams, according to Chu. He said changing the terminology used for these thin melanomas may offer a solution.

Labeling early-stage skin lesions as “uncertain malignant potential” instead of calling them melanomas might not decrease the number of surgeries. Still, it could change how patients perceive the risk.

Like how polyps in the colon are removed preventively, these skin lesion treatments can be seen as preventive care because it’s hard to be certain if these lesions will turn into cancer. Acknowledging this uncertainty is important, even if removing the skin growths remains the ultimate solution, Chu explained.

“To truly solve the ‘over-treatment’ issue, we’d have to discover a way to determine which of these lesions will go on to behave poorly, but that’s a whole other discussion that researchers will continue to work on,” Chu said.

Read Next: Types of Moles (and When to Consider Getting One Checked)

What This Means For You

The high rate of melanoma overdiagnosis in the U.S. leads to unnecessary anxiety for patients, highlighting the need for more precise diagnostic criteria and a reevaluation of how early-stage melanomas should be treated and communicated to patients.

Read the original article on Verywell Health.