Are increased skin screenings leading to overdiagnosis of low-risk melanomas?

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Higher rates of biopsies and melanoma are found in people who have undergone previous skin screening, according to a study. This is especially true with in situ melanoma.

Researchers collected data from 43,762 residents of Australia who were between the ages of 40-69 years at baseline, with no history of melanoma. A comprehensive melanoma risk factor survey was completed at baseline and participants were asked if a skin exam by a doctor had been completed in the previous 3 years. Melanoma incidence in years 2 to 7 of follow-up was calculated using the cancer registry.

Prior to baseline, 73% of patients (n = 28,155) had undergone skin screening. During 197,191 person-years of follow-up, there were 967 first incident melanomas, of which 381 were invasive. Participants who had been screened had higher rates of melanoma and subsequent skin biopsies than unscreened participants.

There was a higher risk associated with skin screening for in situ melanoma, however, this risk was not evident for invasive melanoma (aHR 1.05, 95% CI 0.72-1.54).

A secondary analysis that defined screening as having a skin biopsy in the first year after baseline, found significantly increased risks of melanoma subsequent biopsies compared to participants who did not have a biopsy.

Whiteman DC, Olsen CM, MacGregor S, et al; QSkin Study. The effect of screening on melanoma incidence and biopsy rates. Br J Dermatol. 2022;doi: 10.1111/bjd.21649. Epub ahead of print. PMID: 35531668.