Although many dermatopathologists perceive that melanocytic skin lesions are overdiagnosed, this perception does not alter diagnostic behaviors, according to a study published online April 20 in JAMA Dermatology .

Kathleen F. Kerr, Ph.D., from the University of Washington in Seattle, and colleagues examined practicing U.S. dermatopathologists' perceptions of melanoma overdiagnosis in a survey study involving 115 board-certified and/or fellowship-trained dermatopathologists who viewed a set of 18 skin biopsy cases (five slide sets composed of 90 melanocytic skin lesions).

The researchers found that 68, 47, and 35 percent of the dermatopathologists agreed that overdiagnosis is a public health issue for atypical nevi, melanoma in situ, and invasive melanoma, respectively. The likelihood of perceiving that atypical nevi are overdiagnosed was lower for dermatopathologists with more years in practice: Forty-six percent and 93 percent of dermatopathologists with 20 or more years of experience and with one to four years of experience, respectively, agreed that atypical nevi are overdiagnosed. Dermatopathologists who agreed that all three conditions were overdiagnosed were slightly more likely than other dermatopathologists to diagnose study cases as mild-to-moderate dysplastic nevi, but the difference was not statistically significant. There was no significant difference observed in diagnosing invasive melanoma for dermatopathologists who agreed and those who disagreed that invasive melanoma is overdiagnosed.

"We did not find evidence that dermatopathologists who perceive overdiagnosis differ in their interpretative behavior," the authors write. "Awareness of overdiagnosis among pathologists may not be enough to reduce overdiagnosis."

One author disclosed financial ties to Myriad Genetics.

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