Melanoma overdiagnosis soars among white Americans, study finds

More than half of all melanoma diagnoses among white Americans may be overdiagnosed, according to a new study led by a researcher at Dell Medical School at the University of Texas at Austin.

"Cases of cutaneous melanoma have risen significantly in the U.S. over the last 40 years, without an equivalent rise in mortality—which points to overdiagnosis," said Ade Adamson, M.D., M.P.P., lead author of the study and an assistant professor in the Department of Internal Medicine at Dell Med. "Overdiagnosis happens when a melanoma is diagnosed that is actually harmless. That means the patient may undergo expensive, unnecessary treatments that may do far more harm than good."

The research, published in the journal BMJ Evidence-Based Medicine, found that an estimated 49.7% of melanomas diagnosed in white men and 64.6% in white women were overdiagnosed in 2018—a total of about 83,000 cases. Using national data from 1975 to 2018, researchers also found that the lifetime risk of being overdiagnosed with melanoma increased over the years.

A large proportion of overdiagnosed melanomas are in the earliest stage (Stage 0—also known as melanoma in situ). The authors estimate that 89% of melanoma in situ are overdiagnosed in white men and 85% in white women in the US.

"This study shouldn't dissuade people from getting concerning moles evaluated for melanoma, especially if you are high risk," said Adamson. "However, my hope is that it informs how people receive a melanoma diagnosis and brings awareness to the phenomenon of overdiagnosis an unintended consequence of screening."