My goodness. What the heck is happening in the world? All this nonsense about limiting exposure to the sun has not only lead to an increase in unnecessary cancer diagnosis but also has possibly caused vitamin D deficiencies making us more vulnerable to viruses like SARS-CoV-2.
This study highlights an inconvenient truth: absent metastasis, no definitive diagnostic criteria for the pathological diagnosis of melanoma exist. Because the diagnosis is subjective, pathologists disagree about whether melanoma is present, particularly when faced with lesions in the diagnostic gray zone.16,17 In addition, they are increasingly evaluating small, ambiguous lesions; nearly 90% of melanomas are now thin (<1.0 mm in thickness) (Fig. S2 in the Supplementary Appendix, available with the full text of this article at NEJM). A combination of subjective criteria, increased frequency of ambiguous lesions, and asymmetric incentives (penalties for underdiagnosing but not for overdiagnosing) may explain the lower pathological threshold to diagnose melanoma.
New England Journal of Medicine
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