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New research yields insight into skin cancer overdiagnosis

According to a recent study, half of U.S. dermatopathologists — physicians who examine tissue samples and diagnose skin conditions such as melanoma — report that non-invasive melanoma is overdiagnosed, and one-third thought that invasive melanoma is overdiagnosed.  

Kathleen Kerr
Kathleen Kerr, UW Professor of Biostatistics

“Overdiagnosis is the diagnosis of disease that will never cause a patient harm during their lifetime.It is a thorny problem because both doctors and patients are understandably wary of missing a cancer diagnosis. However, overdiagnosis carries serious harms as well. It means that too many patients receive the devastating news that they have a potentially life-threatening disease,” said lead author Kathleen Kerr, a biostatistician at the University of Washington School of Public Health.

The research, which appears in this month’s Journal of the American Medical Association (JAMA) Dermatology, also compared the various diagnoses that different dermatopathologists gave to a common set of skin biopsy cases.

Researchers thought that the pathologists who perceive overdiagnosis of invasive melanoma might be more reserved in assigning this diagnosis.

The data told a different story.

Those who perceive that invasive melanoma is overdiagnosed were slightly more likely, rather than less likely, to diagnose invasive melanoma on study cases. 

“There is a notion that pathologists who are aware of overdiagnosis will be more cautious in diagnosing cancer. Our study results suggest that this hope may be unfounded,” said Kerr.

Additional coverage: UW News