Histopathologic reassessment of melanoma and other melanocytic skin lesions excised in 2009 and 2018–2019

Gjersvik, Petter; Veierød, Marit Bragelien; Thompson, Alec; Grzyb, Krzysztof; Lilland, Katrine Høeg; Vazov, Nikolay; Roscher, Ingrid; Bassarova, Assia

doi:10.4045/tidsskr.22.0204

Cited by 2 publications

(2 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Concomitant with the rise in skin exams has been an increase in biopsy rate which has been linked to higher detection of early melanoma 37. The thresholds for pathologists to label histopathological slides of pigmented lesions as melanoma has also fallen over time, further contributing to the increasing rate of melanoma diagnosis 38 39. The combination of these factors point to the conclusion that most of the increased detection of melanoma in the USA is likely of overdiagnosed indolent disease.…”

Section: Discussionmentioning

confidence: 99%

Ecological study estimating melanoma overdiagnosis in the USA using the lifetime risk method

Adamson,

Naik,

Jones

et al. 2024

BMJ EBM

View full text Add to dashboard Cite

ObjectivesTo quantify the proportion of melanoma diagnoses (invasive and in situ) in the USA that might be overdiagnosed.DesignIn this ecological study, incidence and mortality data were collected from the Surveillance, Epidemiology and End Results 9 registries database. DevCan software was used to calculate the cumulative lifetime risk of being diagnosed with melanoma between 1975 and 2018, with adjustments made for changes in longevity and risk factors over the study period.SettingUSA.ParticipantsWhite American men and women (1975–2018).Main outcome measuresThe primary outcome was excess lifetime risk of melanoma diagnosis between 1976 and 2018 (adjusted for year 2018 competing mortality and changes in risk factors), which was inferred as likely overdiagnosis. The secondary outcome was an excess lifetime risk of melanoma diagnosis in each year between 1976 and 2018 (adjusted and unadjusted).ResultsBetween 1975 and 2018 the adjusted lifetime risk of being diagnosed with melanoma (invasive and in situ) increased from 3.2% (1 in 31) to 6.4% (1 in 16) among white men, and from 1.6% (1 in 63) to 4.5% (1 in 22) among white women. Over the same period, the adjusted lifetime risk of being diagnosed with melanoma in situ increased from 0.17% (1 in 588) to 2.7% (1 in 37) in white men and 0.08% (1 in 1250) to 2.0% (1 in 50) in white women. An estimated 49.7% of melanomas diagnosed in white men and 64.6% in white women were overdiagnosed in 2018. Among people diagnosed with melanomas in situ, 89.4% of white men and 85.4% of white women were likely overdiagnosed in 2018.ConclusionsMelanoma overdiagnosis among white Americans is significant and increasing over time with an estimated 44 000 overdiagnosed in men and 39 000 in women in 2018. A large proportion of overdiagnosed melanomas are in situ cancers, pointing to a potential focus for intervention.

show abstract

Section: Discussionmentioning

confidence: 99%

Ecological study estimating melanoma overdiagnosis in the USA using the lifetime risk method

Adamson,

Naik,

Jones

et al. 2024

BMJ EBM

View full text Add to dashboard Cite

show abstract

“…Compatible with the previous reports, there was a low agreement between the baseline diagnoses and diagnoses after reevaluation. 16,28 Poorly reproducible histopathological criteria, the lack of details including low and moderate dysplasia in the previous histopathological reports and the dermatopathologist's increasing experience with the features of malignancy over time may have led to a low level of agreement.…”

Section: Low-grade Dysplasiamentioning

confidence: 99%

Can we manage the melanocytic lesions with peripheral globules according to the grade of dysplasia?

Avcı,

Akın,

Lebe

et al. 2024

Aust J Dermatology

View full text Add to dashboard Cite

Background/ObjectivesAlthough excision of melanocytic nevi with high‐grade dysplasia is recommended by the World Health Organization (WHO), clinical studies investigating the approach based on the grading dysplasia of melanocytic lesions with peripheral globules (PGs) are lacking. We investigated the grades of dysplasia and their distinguishable dermoscopic and clinical features to provide accurate data for managing these lesions.MethodsWe retrospectively classified histologically confirmed melanocytic lesions with PGs according to the 2018 WHO Classification of Skin Tumours criteria in a university hospital in Turkey. Dermoscopic features, lesions, and patient characteristics were recorded.ResultsSixty‐six lesions of 56 patients were included. After classification, 9.1% (n: 6) of lesions were melanomas, 39.4% (n: 26) were high‐grade dysplastic nevi, and 50% (n: 33) were low‐grade dysplastic nevi (n: 33, 50%). There was one nevus with no dysplasia (n: 1, 1.5%). Univariate analysis revealed that ≥31 years of age, irregular shape of peripheral globules, black colour, total colour count, and maximum diameter of the lesion were associated with high‐grade dysplasia and melanoma. In the multivariate analyses, ≥31 years of age (OR = 3.80, 95% CI, 1.17–12.37), irregular shape of peripheral globules (OR = 3.90, 95% CI, 1.15–13.2), and total colour count (OR = 3.21, 95% CI, 1.2–8.5) were significant predictive factors for the lesions with high‐grade dysplasia and melanomas.ConclusionsTo avoid the underdiagnosis of both melanomas and high‐grade dysplastic nevi with PGs, the irregular shape of peripheral globules and multiple colours after the third decade may be useful in making an excision decision. The risk increases every 1‐year increase in age. Excision is suggested for all melanocytic lesions with PGs for patients 60 years or older because of the high risk of melanoma and melanocytic nevus with high‐grade dysplasia.

show abstract

Histopathologic reassessment of melanoma and other melanocytic skin lesions excised in 2009 and 2018–2019

Cited by 2 publications

References 11 publications

Ecological study estimating melanoma overdiagnosis in the USA using the lifetime risk method

Ecological study estimating melanoma overdiagnosis in the USA using the lifetime risk method

Can we manage the melanocytic lesions with peripheral globules according to the grade of dysplasia?

Contact Info

Product

Resources

About