The accuracy of skin cancer diagnosis varies between doctors, leading to both over and under reporting of the life-threatening condition, new research suggests.
Moderate-to-severe cases of melanoma – the most severe form of the disease – are the most poorly judged, with up to 40 percent of diagnoses being inaccurate, which could put patients’ lives at risk, a study found.
Yet, mild cases are correctly diagnosed in 92 percent of cases, while severe incidences are accurately reported 72 percent of the time, the research adds.
Researchers believe efforts to improve clinical practice should include the use of a standardized diagnosis reference and the development of more sophisticated tools to support doctors’ verdicts.
The accuracy of skin cancer diagnoses vary according to the doctor, new research reveals
WHAT IS MELANOMA?
It most commonly occurs in moles on men’s backs and women’s legs. Signs include moles getting bigger, changing shape or color, losing symmetry, being painful or itchy, and bleeding or becoming crusty. Overexposure to UV light is the most common cause. UV light comes from the sun and sunbeds. Fair skinned people with red or blonde hair and freckles are most at risk. Age and a family history of the condition also raise the risk. Treatment can include radiotherapy or surgery depending on the cancer’s severity.
How the study was carried out
Researchers from the University of Washington School of Medicine in Seattle analyzed 187 doctors from 10 US states.
The doctors ranked the severity of previously diagnosed melanoma skin lesions.
Each case was then reviewed by a panel of three experienced pathologists.
Pathology involves the diagnosis of a disease based on the analysis of body tissues and fluids.
Accuracy was measured by comparing the doctors’ interpretations with the panel’s diagnosis.
Results revealed that the diagnosis of moderate-to-severe lesions are the least accurate, with up to 40 percent of the doctors’ conclusions differing from the panel’s.
Mild case diagnoses were found to be accurate in 92 percent of cases, while highly invasive incidences were correct 72 percent of the time.
It is unclear why moderate diagnoses are less accurate than mild or severe cases.
The findings were published in the British Medical Journal.
Exposure to UV light is the most common melanoma cause, particularly for those with fair skin
What the research means
According to the researchers, their results demonstrate that melanoma diagnoses ranging from moderate to invasive are often inaccurate.
Efforts to improve clinical practice should include the use of a standardized diagnosis reference and the development of more sophisticated tools to support doctors’ verdicts, they add.
Diagnoses currently rely on assessing skin samples under a microscope, which has previously been criticized for its questionable reliability.
Lead author Dr. Joann Elmore said: ‘The diagnosis is made by a human. There is no molecular marker or machine that will tell us what the diagnosis is,’ Reuters reported.
Yet, the researchers point out that in a real-life setting doctors would have the opportunity to view more skin samples, ask for a second opinion from a colleague and request additional tests before reaching a verdict.
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