Managed Care & Clinical Updates: February 2023
Source: AJMC, February 2023
The increasing rate of melanoma diagnosis in the United States may not be due to actual disease, but possibly it is due to overdiagnosis of patients with an actual very low risk of death, authors of a new study posit. The growing numbers of melanoma diagnosis in recent years may be due to overdiagnosis of skin cancer in patients with a very low risk of death and stage I lesions that are 1 mm or smaller, according to study findings published in Cancer.
“Evidence exists that escalating melanoma incidence is due in part to overdiagnosis, the diagnosis of lesions that will not lead to symptoms or death,” the authors wrote. “Although melanoma is the most serious skin cancer, most patients have high chances of survival. There is evidence that some lesions diagnosed as melanoma would never have caused symptoms or death.”
Investigators used data from the Surveillance, Epidemiology, and End Results Program database. Patients were included in analyses if their melanoma was diagnosed in 2010 or 2011; they had negative clinical lymph nodes; and they had early-stage, small lesions. Risk of death was estimated out to 7 years—patients had to have complete 7-year follow-up data—and logistic models identified a subset of patients in this group who may have had a higher risk of death. Of the 11,594 patients in the study, 46% were women. The median (IQR) age for all participants was 58 years (range, 48-68).