Research Shows Overdiagnosis of Melanoma in White Men & Women

Research Shows Overdiagnosis of Melanoma in White Men & Women

Although melanoma is less common than other forms of skin cancers, it’s considered more dangerous because of its ability to spread to other parts of the body if not detected and treated early. And while the number of melanoma cases has been on the rise in recent decades, mortality rates remain stable.

This has raised a debate about the potential overdiagnosis of melanoma, meaning that these diagnoses of cancer would have never caused any symptoms or problems in a patient’s lifetime.

And since melanoma diagnoses had not been previously estimated in the United States, the first-ever study to do so was conducted in an effort to help clear up the debate. Here’s what we know.

A Look at the Study

The recent cohort study was conducted by researchers at Dell Medical School at the University of Texas at Austin. The researchers looked at melanoma rates among U.S. white and Black patients from 1975 through 2014.

To estimate what proportion of those melanoma cases were overdiagnoses, the team focused on the white population because overdiagnosis is concentrated in this group since they are most likely to get skin exams.

When looking at rates of white and Black patients in the United States from the Surveillance, Epidemiology, and End Results database, the team used trends in melanoma-associated mortality in white patients as a trend for true cancer incidence, and in order to correct for improvements in medical care over time, they used mortality trends in Black Americans.

This marker was then used to estimate expected mortality among white patients if no improvements in medical care were made. Researchers argued this would serve as a marker for change in true cancer occurrence. [MO1] 

What Did the Study Find?

During that time frame, a four-fold increase in melanoma incidence was reported among white women and a six-fold increase among men, in comparison to an incidence increase of less than 25 percent among Black women and men.

In addition, mortality rates decreased by approximately 25 percent in Black men and women, while mortality remained stable among white women and increased by approximately 50 percent in white men.

Based on these findings, the researchers concluded that overdiagnosis occurred in 59 percent of white women and 60 percent of white men in 2014.

Given those high percentages, researchers stress that this overdiagnosis can cause potential harm to the patients that are screened for melanoma and the importance of bringing this underdiscussed topic in dermatology to the forefront.

References

Adamson, Adewole S., Elizabeth A. Suarez, and H. Gilbert Welch. “Estimating Overdiagnosis of Melanoma Using Trends among Black and White Patients in the US.” JAMA Dermatology, 2022. https://doi.org/10.1001/jamadermatol.2022.0139.

Volansky, Rob. “Melanoma Overdiagnosis May Be Common in US White Men, Women.” Healio, March 25, 2022. https://www.healio.com/news/dermatology/20220324/melanoma-overdiagnosis-may-be-common-in-us-white-men-women#:~:text=From%20these%20findings%2C%20the%20researchers,represent%20overdiagnosis%2C%E2%80%9D%20Adamson%20said.