Promoting the Detection of Early-Stage Melanoma in an Age of Overdiagnosis: Don't Throw the Baby Out with the Bathwater

The presentation discusses the importance of detecting early-stage melanoma amidst concerns about overdiagnosis, emphasizing the need to balance vigilance and resource use in screening. The speaker, whose clinical practice focuses on high-risk patients, clarifies that they do not advocate formal melanoma screening due to its low yield and high resource demands. However, they highlight historical increases in melanoma incidence related to rising UV exposure and lifestyle changes, as well as the plateau of incidence observed from 2015 onwards. The discussion includes trends in melanoma mortality, indicating that mortality rates are diverging by age, with older populations experiencing increased mortality while younger populations see a slight decline. The effectiveness of systemic therapies introduced in 2013 in lowering mortality rates is noted. The presentation suggests reframing the conversation around overdiagnosis, arguing for the use of melanoma stage at diagnosis as an endpoint in studies rather than mortality alone. The speaker calls for early detection through skin self-exams, indicating they can lead to better outcomes. They propose enhancing public awareness, utilizing mobile technologies for monitoring, and employing AI-assisted strategies in dermatology to improve melanoma detection while mitigating the risks of overdiagnosis. Finally, the speaker urges continued research into effective prevention strategies and tools that can help in managing the healthcare burden associated with melanoma.