Skin Biopsy Rates and Incidence of Melanoma

Population Based Ecological Study

This study analyzed trends in skin biopsy rates between 1986 and 2001 and their association with changes in the incidence of melanoma. Study data were drawn from Medicare claims data for individuals age 65 and older that reside in one of the nine geographic areas of the U.S. National Cancer Institute's Surveillance Epidemiology and End Results (SEER) program. Based on the evidence that the increase in biopsy rates is associated with an increase in early stage melanoma diagnosis, the researchers suggest the existence of over-diagnosis rather than a true increase in the incidence of melanoma.

Key Findings:

  • The average biopsy rate among people age 65 and older was 2.5 times higher in 2001 than in 1986.
  • For this same population, the average incidence of melanoma was 2.4 times higher in 2001 than in 1986.
  • In the model that controlled for potential increases in the true incidence of melanoma, 1,000 additional biopsies were still associated with the diagnosis of 6.9 additional melanoma cases.
  • There was no significant change in mortality from melanoma between 1986 and 2001.