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Overdiagnosis melanoma

Wolfgang Weyers
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...
April 2018: Dermatology Practical & Conceptual
Kaitlin L Nufer, Anthony P Raphael, H Peter Soyer
No abstract text is available yet for this article.
April 1, 2018: JAMA Dermatology
Alessia Barisani, Salvatore D Infusino, Cosimo Misciali, Beatrice Passarini, Nunzio C Salfi, Elisa Varotti, Annalisa Patrizi
BACKGROUND: Atypical lentiginous melanocytic nevi (ALMNs) are atypical pigmented lesions with histopathological features similar to those of dysplastic nevi, with a lentiginous pattern. Variable histopathological features of ALMNs were observed in our practice. METHODS: We described the histopathological features of ALMNs diagnosed in the period 2009- 2015. Our cases were divided into 2 groups: Group 1: ALMNs showing the same histopathological features as previously described in the literature; Group 2: ALMNs with different features...
December 15, 2017: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
A Znaor
No abstract text is available yet for this article.
September 2017: British Journal of Dermatology
M A Weinstock, J P Lott, Q Wang, L J Titus, T Onega, H D Nelson, L Pearson, M Piepkorn, R L Barnhill, J G Elmore, A N A Tosteson
BACKGROUND: Melanoma incidence has increased in recent decades in the U.S.A. Uncertainty remains regarding how much of this increase is attributable to greater melanoma screening activities, potential detection bias and overdiagnosis. OBJECTIVES: To use a cross-sectional ecological analysis to evaluate the relationship between skin biopsy and melanoma incidence rates over a more recent time period than prior reports. METHODS: Examination of the association of biopsy rates and melanoma incidence (invasive and in situ) in SEER-Medicare data (including 10 states) for 2002-2009...
April 2017: British Journal of Dermatology
Kirsten Bibbins-Domingo, David C Grossman, Susan J Curry, Karina W Davidson, Mark Ebell, John W Epling, Francisco A R García, Matthew W Gillman, Alex R Kemper, Alex H Krist, Ann E Kurth, C Seth Landefeld, Carol M Mangione, William R Phillips, Maureen G Phipps, Michael P Pignone, Albert L Siu
IMPORTANCE: Basal and squamous cell carcinoma are the most common types of cancer in the United States and represent the vast majority of all cases of skin cancer; however, they rarely result in death or substantial morbidity, whereas melanoma skin cancer has notably higher mortality rates. In 2016, an estimated 76,400 US men and women will develop melanoma and 10,100 will die from the disease. OBJECTIVE: To update the 2009 US Preventive Services Task Force (USPSTF) recommendation on screening for skin cancer...
July 26, 2016: JAMA: the Journal of the American Medical Association
Ronald D Barr, Lynn A G Ries, Denise R Lewis, Linda C Harlan, Theresa H M Keegan, Bradley H Pollock, W Archie Bleyer
BACKGROUND: Incidence rates and trends of cancers in adolescents and young adults (AYAs) ages 15 to 39 years were reexamined a decade after the US National Cancer Institute AYA Oncology Progress Review Group was established. METHODS: Data from the Surveillance, Epidemiology, and End Results program through 2011 were used to ascertain incidence trends since the year 2000 of the 40 most frequent cancers in AYAs, including tumors with nonmalignant/noninvasive behavior...
April 1, 2016: Cancer
Babak Monshi, Marin Vujic, Danijel Kivaranovic, Alma Sesti, Willi Oberaigner, Igor Vujic, Susana Ortiz-Urda, Christian Posch, Hans Feichtinger, Monika Hackl, Klemens Rappersberger
AIM OF STUDY: Incidence rates of melanoma, generated by cancer registries (CRs), are susceptible to reporting inconsistencies due to increasing decentralisation of diagnosis. We therefore independently assessed the burden of melanoma in Austria. METHODS: We collected histopathological reports on melanoma of all patients diagnosed in Austria in 2011. Demographic and clinical characteristics, histopathological tumour stages were assessed. Their regional distributions and incidence rates were analysed and compared with data of national and international CRs...
March 2016: European Journal of Cancer
Robert J T van der Leest, Judith Zoutendijk, Tamar Nijsten, Wolter J Mooi, Jasper I van der Rhee, Esther de Vries, Loes M Hollestein
BACKGROUND: A disproportional increase in in situ or thin melanomas may point at underlying causes such as increased melanoma awareness, as well as 'overdiagnosis' of melanoma in diagnostically equivocal small lesions. OBJECTIVES: The purposes of this study were to estimate trends in melanoma incidence by sex, Breslow thickness (thin melanomas subdivided into four subgroups: <0.25 mm, 0.25-0.49 mm, 0.50-0.74 mm, and 0.75-1.0 mm), age and location, and to compare these with trends in subgroups of thicker melanomas...
December 2015: European Journal of Cancer
Emanuele Crocetti, Sandra Mallone, Trude Eid Robsahm, Anna Gavin, Domenic Agius, Eva Ardanaz, Maria-Dolores Chirlaque Lopez, Kaire Innos, Pamela Minicozzi, Lorenzo Borgognoni, Daniela Pierannunzio, Nora Eisemann
BACKGROUND: In Europe skin melanoma (SM) survival has increased over time. The aims were to evaluate recent trends and differences between countries and regions of Europe. METHODS: Relative survival (RS) estimates and geographical comparisons were based on 241,485 patients aged 15years and over with a diagnosis of invasive SM in Europe (2000-2007). Survival time trends during 1999-2007 were estimated using the period approach, for 213,101 patients. Age, gender, sub-sites and morphology subgroups were considered...
October 2015: European Journal of Cancer
Jérôme Viguier
The past 20 years have seen major advances in screening for different cancer types. Screening is however destined to evolve, in terms of target populations, procedures used and the overall positioning of screening in the fight against the different forms of cancer. At the same time, screening is expected progressively to become more closely tailored to the level of risk; the type of tests and the frequency with which they are used will be adjusted in a more personalized approach. A critical issue is also to provide the population at large with more extensive information on the advantages and disadvantages, particularly of screening programmes known for the potentially high rate of overdiagnosis...
June 2015: European Journal of Cancer Prevention
Jamie L Carter, Russell J Coletti, Russell P Harris
OBJECTIVE: To determine the optimal method for quantifying and monitoring overdiagnosis in cancer screening over time. DESIGN: Systematic review of primary research studies of any design that quantified overdiagnosis from screening for nine types of cancer. We used explicit criteria to critically appraise individual studies and assess strength of the body of evidence for each study design (double blinded review), and assessed the potential for each study design to accurately quantify and monitor overdiagnosis over time...
2015: BMJ: British Medical Journal
Hyunsoon Cho, Angela B Mariotto, Lisa M Schwartz, Jun Luo, Steven Woloshin
BACKGROUND: It is often assumed that increases in cancer survival reflect true progress against cancer. This is true when these increases are accompanied by decreased burden of disease: Fewer people being diagnosed or dying from cancer (ie, decreased incidence and mortality). But increased survival can also occur even when incidence is increasing and mortality is unchanged. OBJECTIVE: To use trends in cancer burden-incidence and mortality-to illustrate when changes in survival reflect true progress...
November 2014: Journal of the National Cancer Institute. Monographs
David P Arps, Douglas R Fullen, May P Chan
AIMS: Melanocytic naevi on the umbilicus have been described as a form of flexural naevi, with the most common feature being a 'nested and dyshesive pattern'. We have encountered a distinct group of umbilical naevi with more significant atypia and prominent fibrosis, not reported previously. This study aimed to characterize these naevi more clearly. METHODS AND RESULTS: Eighty-one umbilical naevi from 2000 to 2013 were reviewed retrospectively, 20 cases of which showed lamellar fibrosis and atypia and were designated as atypical umbilical naevi (AUN)...
February 2015: Histopathology
E Sparreboom, C Wetzels, M Verdijk, S Mulder, W Blokx
Angiomatoid fibrous histiocytoma is an uncommon soft-tissue tumor of intermediate malignancy that is often misdiagnosed initially. As there is not one immunohistochemical marker that consequently stains positive or negative for angiomatoid fibrous histiocytoma, molecular diagnostics are becoming more widely used. So far three translocations have been reported to arise in angiomatoid fibrous histiocytoma: FUS-ATF1, EWSR1-CREB1, or EWSR1-ATF1. We present a case of angiomatoid fibrous histiocytoma on the upper arm of a 40-year-old female, which was initially misdiagnosed as metastatic melanoma in a lymph node...
2012: Case Reports in Pathology
Vincenzo De Giorgi, Alessia Gori, Marta Grazzini, Susanna Rossari, Teresa Oranges, Anna Sara Longo, Torello Lotti, Sara Gandini
The incidence of cutaneous malignant melanoma is continuously increasing worldwide, but only minimal changes in mortality have been observed. This phenomenon has brought into question whether this increased incidence reflects a true or apparent melanoma epidemic. The most recent data suggest that this epidemiological trend may be explained by the existence of a certain degree of melanoma overdiagnosis, especially of thin lesions, which probably would never progress to advanced disease if left untreated. However, acute sun exposure and widespread use of sunbeds may also justify the increase in melanoma incidence...
September 2012: Dermatologic Therapy
Katrin Kerl, Werner Kempf, Jivko Kamarashev, Giulia Spallone, Ralph Braun, Thomas Wiesner, Lars E French, Reinhard Dummer
BACKGROUND: Transepidermal melanocytic migration (TEM) is an important diagnostic criterion for malignancy, especially in association with cytologic atypia. However, TEM may also be observed in benign melanocytic tumors, such as Spitz nevus, acral nevi, or nevi in infancy. We discuss the value of TEM for the diagnosis of melanocytic tumors in a young patient previously diagnosed as having 11 cutaneous melanomas. OBSERVATION: A 17-year-old patient with a history of 11 cutaneous melanomas diagnosed in the past 3 years by different expert dermatopathologists presented in our department...
February 2012: Archives of Dermatology
Earl J Glusac
The rise in malignant melanoma incidence has been termed "epidemic". Closer scrutiny of epidemiologic data suggests overdiagnosis as the true cause of the dramatic rise in melanoma incidence. In epidemiologic terms, "overdiagnosis" describes lesions that are histologically malignant but biologically benign. Overdiagnosis is not unique to melanoma screening but is prevalent in screening for cancers of other organs, including the thyroid and prostate glands.
January 2012: Journal of Cutaneous Pathology
Wolfgang Weyers
In the past decades, the incidence of melanoma has been reported to rise in epidemic proportions. The chief reason for that pseudo-epidemic is improved criteria for diagnosis that allow melanomas to be recognized far more accurately and at earlier stages. The rising number of melanomas diagnosed has resulted in increased diagnostic scrutiny, more pigmented lesions being biopsied and more melanomas recognized, thus enhancing the 'epidemic' in self-perpetuating fashion. Regression of melanomas may, in part, explain why lesions undetected before did not result in a far higher mortality...
January 2012: Journal of Cutaneous Pathology
Thomas Brenn
The pathology of melanocytic tumours remains one of the most challenging and controversial fields in diagnostic histopathology, and it is one of the leading causes for litigation against pathologists. This is due largely to the wide morphological spectrum and often only subtle differentiating features with potential for both under- as well as overdiagnosis of melanoma. Particular pitfalls include the diagnosis of rare and unusual melanoma variants and melanoma resembling naevi. Furthermore, a subset of benign naevi may show concerning features associated more typically with a diagnosis of melanoma...
April 2012: Histopathology
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