Screening for malignant melanoma—a critical assessment in historical perspective

Screening for melanoma has been advocated for many years because early detection and excision have been regarded as the most important measure to lower mortality from that neoplasm. In the past decade, concern has been raised by epidemiologists that screening might result in excision chiefly of “in...

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Autor principal:	Wolfgang Weyers
Formato:	article
Lenguaje:	EN
Publicado:	Mattioli1885 2018
Materias:	melanoma screening overdiagnosis Dermatology RL1-803
Acceso en línea:	https://doaj.org/article/e0525534fec6450fb6043fc56b3a23c8
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spelling	oai:doaj.org-article:e0525534fec6450fb6043fc56b3a23c82021-11-17T08:30:12ZScreening for malignant melanoma—a critical assessment in historical perspective10.5826/dpc.0802a062160-9381https://doaj.org/article/e0525534fec6450fb6043fc56b3a23c82018-04-01T00:00:00Zhttp://dpcj.org/index.php/dpc/article/view/430https://doaj.org/toc/2160-9381 Screening for melanoma has been advocated for many years because early detection and excision have been regarded as the most important measure to lower mortality from that neoplasm. In the past decade, concern has been raised by epidemiologists that screening might result in excision chiefly of “inconsequential cancer,” i.e., melanomas that would never have progressed into life-threatening tumors, a phenomenon referred to by the misleading term “overdiagnosis.” Without any firm evidence, that speculation has been embraced worldwide, and incipient melanomas have been trivialized. At the same time, efforts at early detection of melanoma have continued and have resulted in biopsy of pigmented lesions at a progressively earlier stage, such as lesions with a diameter of only 2, 3, or 4 mm. Those tiny lesions often lack sufficient criteria for clinical and histopathologic diagnosis, the result being true overdiagnoses, i.e., misdiagnoses of melanocytic nevi as melanoma. This is especially true if available criteria for histopathologic diagnosis are diminuished even further by incomplete excision of lesions. The reliability of histopathologic diagnosis is far higher in excisional biopsies of lesions that were given some more time to develop changes that make them recognizable. Biopsy of pigmented lesions with a diameter of 6 mm has been found to result in a far higher yield of melanomas. In addition to better clinical judgment, slight postponement of biopsies bears the promise of substantial improvement of the reliability of histopathologic diagnosis, and of alleviating true overdiagnoses. Wolfgang WeyersMattioli1885articlemelanomascreeningoverdiagnosisDermatologyRL1-803ENDermatology Practical & Conceptual, Vol 8, Iss 1 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	melanoma screening overdiagnosis Dermatology RL1-803
spellingShingle	melanoma screening overdiagnosis Dermatology RL1-803 Wolfgang Weyers Screening for malignant melanoma—a critical assessment in historical perspective
description	Screening for melanoma has been advocated for many years because early detection and excision have been regarded as the most important measure to lower mortality from that neoplasm. In the past decade, concern has been raised by epidemiologists that screening might result in excision chiefly of “inconsequential cancer,” i.e., melanomas that would never have progressed into life-threatening tumors, a phenomenon referred to by the misleading term “overdiagnosis.” Without any firm evidence, that speculation has been embraced worldwide, and incipient melanomas have been trivialized. At the same time, efforts at early detection of melanoma have continued and have resulted in biopsy of pigmented lesions at a progressively earlier stage, such as lesions with a diameter of only 2, 3, or 4 mm. Those tiny lesions often lack sufficient criteria for clinical and histopathologic diagnosis, the result being true overdiagnoses, i.e., misdiagnoses of melanocytic nevi as melanoma. This is especially true if available criteria for histopathologic diagnosis are diminuished even further by incomplete excision of lesions. The reliability of histopathologic diagnosis is far higher in excisional biopsies of lesions that were given some more time to develop changes that make them recognizable. Biopsy of pigmented lesions with a diameter of 6 mm has been found to result in a far higher yield of melanomas. In addition to better clinical judgment, slight postponement of biopsies bears the promise of substantial improvement of the reliability of histopathologic diagnosis, and of alleviating true overdiagnoses.
format	article
author	Wolfgang Weyers
author_facet	Wolfgang Weyers
author_sort	Wolfgang Weyers
title	Screening for malignant melanoma—a critical assessment in historical perspective
title_short	Screening for malignant melanoma—a critical assessment in historical perspective
title_full	Screening for malignant melanoma—a critical assessment in historical perspective
title_fullStr	Screening for malignant melanoma—a critical assessment in historical perspective
title_full_unstemmed	Screening for malignant melanoma—a critical assessment in historical perspective
title_sort	screening for malignant melanoma—a critical assessment in historical perspective
publisher	Mattioli1885
publishDate	2018
url	https://doaj.org/article/e0525534fec6450fb6043fc56b3a23c8
work_keys_str_mv	AT wolfgangweyers screeningformalignantmelanomaacriticalassessmentinhistoricalperspective
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Screening for malignant melanoma—a critical assessment in historical perspective

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