title: Melanocytic lesions excised from the skin: what percentage are malignant?
abstract: We estimated the diagnostic skill of clinicians managing melanocytic skin naevi by measuring the percentage of malignant melanomas, premalignant and potentially malignant naevi, in 1896 excised melanocytic lesions submitted to a pathology service over 11 weeks. They comprised 8 per cent. The percentage increased with age: 4 per cent in the under-40s, 17 per cent in those aged 40-59, and 30 per cent in those over 60, (P < 0.001, sex-adjusted). Although the percentage was twice as high in males (11 per cent) as females (6 per cent), after adjustment for age the difference was not significant. Invasive melanomas, 3 per cent of the total, were similar: 1 per cent were from under-40s; 7 per cent from those aged 40-59 years; and 14 per cent from those over 60. They comprised 4 per cent of lesions from males and 2 per cent from females. These trends may indicate poor specificity of clinical diagnosis, notwithstanding other reasons for removal of naevi (cosmetic), particularly among patients under 40, and females.
authors.affiliation: Department of Social and Preventive Medicine, University of Queensland, Brisbane.
authors.forename: C
authors.initials: C
authors.lastname: Del Mar
authors.forename: A
authors.initials: A
authors.lastname: Green
authors.forename: T
authors.initials: T
authors.lastname: Cooney
authors.forename: K
authors.initials: K
authors.lastname: Cutbush
authors.forename: S
authors.initials: S
authors.lastname: Lawrie
authors.forename: G
authors.initials: G
authors.lastname: Adkins
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008545:Melanoma / Q000145:classification / Q000473:pathology*; D008875:Middle Aged; D009506:Nevus / Q000473:pathology; D012680:Sensitivity and Specificity; D012737:Sex Factors; D012878:Skin Neoplasms / Q000145:classification / Q000473:pathology*