Impact of alternative diagnostic labels for melanoma in situ on management choices and psychological outcomes: protocol for an online randomised study DOI Creative Commons

Zhongfei Wu,

Brooke Nickel, Farzaneh Boroumand

et al.

BMJ Open, Journal Year: 2024, Volume and Issue: 14(12), P. e089558 - e089558

Published: Dec. 1, 2024

A diagnosis of melanoma in situ presents negligible risk to a person's lifespan or physical well-being, but existing terminology makes it difficult for patients distinguish these from higher invasive melanomas. This study aims explore whether using an alternative label may influence patients' management choices and anxiety levels. is between-subjects randomised online experiment, hypothetical scenarios. Following consent, eligible participants will be 1:1:1 three labels: 'melanoma situ' (control), 'low-risk melanocytic neoplasm' (intervention 1) neoplasm, 2). The required sample size 1668 people. co-primary outcomes are (1) choice between no further surgery ensure clear histological margins greater than 5 mm (2) patient-initiated clinical follow-up when needed (patient-led surveillance) regular routinely scheduled (clinician-led surveillance). Secondary include anxiety, perceived dying (after choice). We make pairwise comparisons across the diagnostic groups regression models (univariable multivariable). has been registered with Australian New Zealand Clinical Trials Registry (ACTRN12624000740594). Ethics approval received University Sydney Human Research Committee (2024/HE000019). results published peer-reviewed medical journal, plain language summary findings shared on Wiser Healthcare publication page (https://www.wiserhealthcare.org.au/category/publications/). (ID 386943).

Language: Английский

Distress and Its Determinants in 820 Consecutive Melanoma Patients DOI Creative Commons
Markus Reitmajer,

Petra Riedel,

Claus Garbe

et al.

Cancer Medicine, Journal Year: 2025, Volume and Issue: 14(6)

Published: March 1, 2025

ABSTRACT Background Psycho‐oncological burden not only affects patients' mental health but can also decrease treatment compliance and impair outcomes. The Distress Thermometer ( DT ) is a widely used screening tool in real‐world medical care for identifying monitoring psychological distress. Patients with melanoma presenting oncologic outpatient departments comprise wide range of characteristics. Although young adults may face challenges related to pivotal life stages, such as career responsibilities or parenting, older often contend mobility issues, preexisting comorbidities, age‐related physical limitations. Methods We conducted retrospective evaluation data from 820 patients treated at our department between July September 2016. These underwent routine completed the associated National Comprehensive Cancer Network (NCCN) Problem List. study aimed identify factors influencing values above threshold (≥ 5), further characterizing complaints according NCCN Results A total psycho‐oncological screening. More than 40% had threshold. Significant over included female gender, younger age, advanced stages III – IV . Analysis List revealed fear, sleep tingling hands feet, feeling swollen, problems work school, concerns regarding God, loss faith. Conclusion results indicate high need support melanoma. Particular attention should be given identified that are exceeding

Language: Английский

Citations

0
Estimating the magnitude and healthcare costs of melanoma in situ and thin invasive melanoma overdiagnosis in Australia DOI
Daniel Lindsay, Katy Bell, Catherine M. Olsen

et al.

British Journal of Dermatology, Journal Year: 2024, Volume and Issue: 191(6), P. 906 - 913

Published: July 19, 2024

Abstract Background Research suggests that a high proportion of melanoma in situ (MIS) may be overdiagnosed, potentially contributing to overtreatment, patient harm and inflated costs for individuals healthcare systems. However, Australia-wide estimates the magnitude overdiagnosis are outdated there has been no estimation cost system. Objectives To estimate overdiagnosed MIS thin invasive melanomas Australia. Methods Using two different methods calculate lifetime risk, we used routinely collected national-level data (stage IA) Australia 2017 2021, separately men women. We multiplied number by estimated annual or melanoma, quantify financial burden Australian system year following diagnosis. Results 67–70% were 2017, rising 71–76% between 19 829 [95% confidence interval (CI) 553–20 105] 20 811 (95% CI 528–21 094) cases MIS. In ranged $17.7 million dollars (AUD; 95% 17.4–17.9 million) AUD$18.6 18.3–18.8 million). 22–29% 28–34% 2831 2726–2935) 3168 3058–3279) melanomas. from overdiagnoses AUD$2.5 2.4–2.6 AUD$2.8 2.7–2.9 Conclusions Melanoma is growing clinical public health problem Australia, producing significant economic overdiagnosis. Limiting prevent unnecessary resource use improve sustainability within

Language: Английский

Citations

2
Fear of Cancer Recurrence Among Survivors of Localized Cutaneous Melanoma—What’s in a Name?—Reply DOI

Ayisha N. Mahama,

Courtney N. Haller, Adewole S. Adamson

et al.

JAMA Dermatology, Journal Year: 2024, Volume and Issue: 160(10), P. 1135 - 1135

Published: Aug. 28, 2024

Our website uses cookies to enhance your experience. By continuing use our site, or clicking "Continue," you are agreeing Cookie Policy | Continue JAMA Dermatology HomeNew OnlineCurrent IssueFor Authors Podcast Journals Network Open Cardiology Health Forum Internal Medicine Neurology Oncology Ophthalmology Otolaryngology–Head & Neck Surgery Pediatrics Psychiatry Archives of (1919-1959) JN Learning / CMESubscribeJobsInstitutions LibrariansReprints Permissions Terms Use Privacy Accessibility Statement 2024 American Medical Association. All Rights Reserved Search Archive Input Term Sign In Individual inCreate an Account Access through institution Purchase Options: Buy this article Rent Subscribe the journal

Language: Английский

Citations

1
Fear of Cancer Recurrence Among Survivors of Localized Cutaneous Melanoma—What’s in a Name? DOI
Elliot H. Akama‐Garren, Rebecca I. Hartman

JAMA Dermatology, Journal Year: 2024, Volume and Issue: 160(10), P. 1135 - 1135

Published: Aug. 28, 2024

Our website uses cookies to enhance your experience. By continuing use our site, or clicking "Continue," you are agreeing Cookie Policy | Continue JAMA Dermatology HomeNew OnlineCurrent IssueFor Authors Podcast Journals Network Open Cardiology Health Forum Internal Medicine Neurology Oncology Ophthalmology Otolaryngology–Head & Neck Surgery Pediatrics Psychiatry Archives of (1919-1959) JN Learning / CMESubscribeJobsInstitutions LibrariansReprints Permissions Terms Use Privacy Accessibility Statement 2024 American Medical Association. All Rights Reserved Search Archive Input Term Sign In Individual inCreate an Account Access through institution Purchase Options: Buy this article Rent Subscribe the journal

Language: Английский

Citations

0
Melanoma Diagnosis in the Mihm Era—And Beyond DOI Creative Commons
David E. Elder

Journal of Cutaneous Pathology, Journal Year: 2024, Volume and Issue: unknown

Published: Nov. 3, 2024

ABSTRACT During the illustrious career of Martin C. Mihm Jr., MD, diagnosis melanoma underwent significant changes, to which he made many contributions. In early descriptions, melanomas were fungating tumor masses that obviously malignant, and highly lethal. seminal work by Dr. his mentor, Wallace H. Clark, phases development these neoplasms recognized distinguished from more advanced disease. It was generally believed stage melanoma, termed radial growth phase (RGP) characterized absence vertical (VGP) favorable microstaging attributes could be recognized, excised, cured, thus preventing However, strenuous efforts in this direction over several decades have resulted little or no change mortality, leading recognition neoplasms, at least, may not true biological malignancies, conclusion overdiagnosis commonly occurs disease, is defined as representing a neoplasm would had capacity cause death symptoms lifetime host. Although there other subsets category, an important category concentrated T1a lack VGP. If can with sensitive specific criteria, already available, changes terminology appropriate, recognizing some them low malignant potential, whereas others all for metastasis warrant use term “melanoma.”

Language: Английский

Citations

0
Impact of alternative diagnostic labels for melanoma in situ on management choices and psychological outcomes: protocol for an online randomised study DOI Creative Commons

Zhongfei Wu,

Brooke Nickel, Farzaneh Boroumand

et al.

BMJ Open, Journal Year: 2024, Volume and Issue: 14(12), P. e089558 - e089558

Published: Dec. 1, 2024

A diagnosis of melanoma in situ presents negligible risk to a person's lifespan or physical well-being, but existing terminology makes it difficult for patients distinguish these from higher invasive melanomas. This study aims explore whether using an alternative label may influence patients' management choices and anxiety levels. is between-subjects randomised online experiment, hypothetical scenarios. Following consent, eligible participants will be 1:1:1 three labels: 'melanoma situ' (control), 'low-risk melanocytic neoplasm' (intervention 1) neoplasm, 2). The required sample size 1668 people. co-primary outcomes are (1) choice between no further surgery ensure clear histological margins greater than 5 mm (2) patient-initiated clinical follow-up when needed (patient-led surveillance) regular routinely scheduled (clinician-led surveillance). Secondary include anxiety, perceived dying (after choice). We make pairwise comparisons across the diagnostic groups regression models (univariable multivariable). has been registered with Australian New Zealand Clinical Trials Registry (ACTRN12624000740594). Ethics approval received University Sydney Human Research Committee (2024/HE000019). results published peer-reviewed medical journal, plain language summary findings shared on Wiser Healthcare publication page (https://www.wiserhealthcare.org.au/category/publications/). (ID 386943).

Language: Английский

Citations

0