First do no harm
Dr. Halpern offered a note of caution regarding melanoma screening: Although it sounds great in theory because it’s relatively cheap, the lesions are accessible on the surface of the skin, and there is the potential to save many life-years, it’s also imperative to consider the potential harms. Perhaps the biggest of these, Dr. Halpern said, is the psychological damage caused by turning a patient with an indolent, low-risk melanoma or nonmelanoma skin cancer into a cancer patient.
"We have to be really, really careful to look at the harms involved in screening. To my mind, one of the biggest problems of melanoma screening is the psychological harm we do by giving people cancer. I’m especially bothered about the way we do that with patients who develop melanoma in situ or microinvasive disease," he said.
"Believe me, if I had melanoma in situ or microinvasive melanoma, I would want you to find it and take if off for me. What I don’t want you to do is to turn me into a cancer patient. I don’t think that’s in the patient’s best interest whatsoever. We don’t do it intentionally, but as dermatologists we have this tendency to dramatically overplay the importance of these diagnoses," Dr. Halpern said.
Dr. Halpern reported having financial relationships with Scibase, DermTech, Caliber, and Canfield.
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