Expanding the toolbox: what is new in melanoma detection?

Malignant melanoma is one of the most common cancers diagnosed. Early detection is important for disease progression. An update was given on novel, promising screening methods, although the target population should be carefully selected.

Prof. James Grichnik (University of South Florida, FL, USA) presented an overview of current methods and new developments in the malignant melanoma landscape [1]. The rationale for screening is that early detection and removal of lesions should prevent progression, morbidity, and mortality. However, screening people without skin lesions would identify people who would never have symptoms, leading to overdiagnosis. A recently published review showed that screening of the general population for malignant melanoma is not supported by current evidence [2]. The overall number needed to treat (NNT) for malignant melanoma is 9.7; corresponding to an NNT of 22.6 for primary care, 9.6 for dermatology, and 5.9 for pigmented lesion specialists.

Tools that are used to improve the accuracy of detection include the use of total body photography. It can improve early detection for high-risk populations. However, the target population that should be imaged and followed needs to be better investigated. Dermoscopy is another tool to help diagnose malignant melanoma. Moreover, smartphone applications for detecting malignant melanoma by non-specialist users looks promising, especially for educational purposes, but they still have a long way to go. An area that is ready for implementation is confocal microscopy, a non-invasive technique that allows examination of the skin with cellular resolution. Electrical impedance has also been shown to improve the sensitivity of diagnosing lesions. Finally, molecular testing may be useful by decreasing the rate of false-positive diagnoses when standard methods show inconclusive results.

Overall, the new technologies for earlier detection of malignant melanoma look promising and rapidly evolving.

1. 
   
   1. Grichnik J. Update on melanoma detection. Update talks, ICD 2021, 10–13 November.
   2. Johansson M, et al. Cochrane Database Syst Rev. 2019 Jun 3;6(6):CD012352.

 

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Posted on 2 December, 20212 December, 2021