{
  "abstract": "Objectives Melanoma early detection efforts by dermatologists have led to a rising incidence of localized melanoma without a corresponding decrease in late-stage disease or mortality, raising concerns about overdiagnosis. However, little is known about dermatologists’ perspectives on melanoma screening and overdiagnosis. The objective of this study was to explore dermatologists’ views on melanoma screening and overdiagnosis and whether information about overdiagnosis should be communicated to patients and the public.Method Semi-structured interviews were conducted of fifteen United States board-certified dermatologists recruited via 2 email listservs (local and national). Interviews were conducted from January-April 2024. Thematic analysis of interviews on melanoma screening and overdiagnosis were performed.Results Dermatologists (mean age 43.7, range 33–60 years; 53% women, all non-Hispanic, and 67% White) described the benefits of melanoma screening including early detection, patient education, and reassurance. They also reported potential psychological, physical, and economic harms of melanoma screening. Many dermatologists felt the harms of screening did not outweigh the potential benefit. They acknowledged melanoma overdiagnosis as a phenomenon but thought that it mostly happened in other clinician practices due to excessive biopsies, and main source of the phenomenon were pathologists who overinterpret histologic slides. Dermatologists expressed uncertainty and hesitation about discussing overdiagnosis with patients and the public.Conclusions Dermatologists recognized both the benefits and harms of melanoma screening, with many believing that the potential benefits outweighed the harms. While overdiagnosis was acknowledged as a concern at the population level, most dermatologists did not perceive it as a significant issue in their own practices or view themselves as contributors to the problem. Instead, they attributed overdiagnosis primarily to pathologists’ diagnostic decision-making. Furthermore, dermatologists were reluctant to discuss the potential harms of melanoma screening, including overdiagnosis, with patients or the public. This reluctance has important implications for shared decision-making, informed consent in melanoma screening, and efforts to address melanoma overdiagnosis.",
  "authors": [
    {
      "affiliations": [
        "University of Texas at Austin, Austin, USA"
      ],
      "name": "Adewole Adamson"
    },
    {
      "affiliations": [
        "University of Texas at Austin, Austin, USA"
      ],
      "name": "Jocelyn Labrada"
    },
    {
      "affiliations": [
        "University of Texas at Austin, Austin, USA"
      ],
      "name": "Srivani Mandaloju"
    },
    {
      "affiliations": [
        "Roskilde University, Roskilde, Denmark"
      ],
      "name": "Alexandra Jønsson"
    },
    {
      "affiliations": [
        "University of Copenhagen, Copenhagen, Denmark"
      ],
      "name": "John Brodersen"
    },
    {
      "affiliations": [
        "University of Sydney, Sydney, Australia"
      ],
      "name": "Anne Cust"
    },
    {
      "affiliations": [
        "University of Texas Health Science Center at San Antonio, San Antonio, USA"
      ],
      "name": "Joel Tsevat"
    },
    {
      "affiliations": [
        "Duke University School of Medicine, Durham, USA"
      ],
      "name": "Michael Pignone"
    }
  ],
  "title": "105 Dermatologists’ perspectives on melanoma screening and overdiagnosis",
  "uid": "c0ee049c-db65-5758-8ae4-403678b2ffed"
}