NEW YORK (Reuters Health) - Many dermatopathologists think atypical nevi, melanoma in situ and invasive melanoma are overdiagnosed, but awareness does not seem to change their behavior, a survey study found.
"Overdiagnosis of diseases such as melanoma is a complicated problem and probably won't have a simple solution," Dr. Kathleen Kerr of the University of Washington in Seattle told Reuters Health by email. "An interesting finding in our research is that a majority of dermatopathologists agree that they see cases in their practice that should not have been biopsied in the first place."
"While it isn't entirely clear why they think this, it suggests that overdiagnosis may originate with primary care doctors and dermatologists performing too many skin biopsies," she said. "Pathologists overcalling cases then compounds the problem."
"As a biostatistician, I find the evidence for melanoma overdiagnosis very compelling," she added. "Population-level data show that melanoma diagnoses have increased dramatically while melanoma mortality has remained nearly constant over a period with no major advances in treatment."
"Therefore, I was surprised that only one-third of dermatopathologists in our study agreed that invasive melanoma is overdiagnosed," she said. "That means that most are either not aware of the evidence or unconvinced."
