Melanoma Screening

Melanoma screening remains extremely popular. Over the last 40 years the incidence of melanoma has increased 6 fold. Melanoma screening is offered to the public as a preventive against the consequences of the disease, metastasis and death. But whether melanoma screening delivers on its promise or instead dramatically boosts the likelihood of overdiagnosis of lesions unlikely to cause harm remains an issue.

Due to melanoma screening, melanoma of the skin now ranks as the 3rd most prevalent cancer just behind breast and lung cancer. More than 200,000 cases will be diagnosed this year with the number of invasive lesions equal to the number of very superficial, non-invasive malignant melanoma in situ. During this same time period the incidence of thyroid cancer increased only 3 fold while breast cancer rose by only 50%.

An article in the January 7, 2021 edition of The New England Journal of Medicine written by eminent physician researchers specializing in public health, pathology and dermatology investigated this situation. They find that in spite of the incidence rising 600% the death rate remained unchanged over the 40 year time frame.

The threshold for diagnosing melanoma on clinical grounds and by microscopic analysis appears considerably less stringent that in the past. Pathologists asked to reevaluate biopsy specimens from 20 years ago changed the diagnosis from a benign lesion to melanoma in a considerable number of cases.

Additionally media focus on melanoma screening has sensitized people to the potential hazards of the disease. But the American Academy of Dermatology discontinued their “Spot Me” campaign when dermatologists suggested further evaluation for possible melanoma in an exorbitant number of those attending melanoma screening.

Financial incentives and utilization of magnifying dermoscopy and now artificial intelligence further worsen the situation.

[damoncus]

This is the smartest MD I’ve ever heard. The wealth of subjects and the details in each….

How this doctor doesn’t have 1M+ subs it ridiculous.

It’s medically correct, succinct and a ton of information in 30 min.

Keep it up Doctor and thank you.

[thephoenix]

Ken, I am your biggest fan. I absolutely love listening to you. Most people talk to slow for me and I can barely listen to them. Your videos are so informative and your style is so easy for me to absorb. Could you possibly do a video on Ivermectin?

[centyrone]

Very interesting article from Welch et al. Was happy to see you cover it.

[supernova]

You always have to worry about the upselling of unnecessary procedures in a strictly profit-driven Healthcare System

[Mark_Ocain]

I know someone who's been recently diagnosed...he has two lessons, one is quite a bit thicker than the other - I don't think he ever used a tanning bed. I am very worried about him progressing to mets. I've used tanning beds very infrequently. One time one burned me quite decently. I guess I should be worried even more for myself. Here in Australia, we have quite a bit of Melanoma in the population.

[leonk]

@wellnowdoctor, have you heard of the non-invasive sticker version of melanoma testing? It tests on a genomic level.

[huntertheparmesancheesesmo]

I wish you would remove that really loud intro/outro music. I love listening to your videos at night time before bed it's interesting and relaxing but those loud noises at the beginning and end keep me from dozing off.

[lucygoose]

Can you talk about mammograms? Doesn’t make sense to me to smash breast tissue and add radiation. Am I way off here?

[RyanG]

Could you do a video on indomethacin ?

[rbend]

Can you do a video on Doxylamine?? Thank you for all that you do! :)

[sarahgupton]

My son’s best friend died of melanoma at age 42. It was discovered early, treated (presumably cured), returned 3 years later and nothing could help. Take it seriously.

[ian]

Could you do a video on each of the personality disorders and other mental health related issues (not drugs)?

[franktartan]

Thanks Ken....but you have great skin...