Perspectives of United States dermatologists on melanoma screening and overdiagnosis: a qualitative study.

Background: Early detection efforts in melanoma 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. Objectives: To explore US dermatologists' views on melanoma screening and overdiagnosis and whether information about overdiagnosis should be communicated to patients and the public. Methods: Data were collected from semistructured qualitative interviews ( Results: Dermatologists [8 woman (53%) and 7 (47%) men, all of whom were non-Hispanic ( Conclusions: US dermatologists recognized 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, especially without the backing of a professional organization. This reluctance has important implications for shared decision-making, informed consent in melanoma screening and efforts to address melanoma overdiagnosis.