title: Diagnosis of pigmented skin tumours in a dermatological setting: different aspects of the number needed to excise as a measure of efficiency.
abstract: The increasing incidence of melanoma prompts a need for efficient management of this patient group. In this study, we use the number needed to excise (NNE), as a measurement of the efficiency of diagnosing melanoma. From January 2009 to December 2012, postoperative records from all patients were prospectively registered. All excised tumours with the histopathological diagnosis of naevus, melanoma or seborrhoeic keratosis were included. NNE values, both excluding and including seborrhoeic keratosis, changes over time, as well as patient- and tumour-related factors influencing NNE were determined. In total, 1,717 cases were included. The overall NNE value was 6.5, and the value fell significantly (r = 0.959, p = 0.041) during the 4-year study period from 8.2 to 4.8. NNE values decreased with increasing patient age to 1.8 in patients ≥ 80 years of age. The overall NNE value including seborrhoeic keratosis was 6.8.
authors.affiliation: Department of Dermatology, Helsingborg Hospital, Department of Clinical Sciences, Faculty of Medicine, Lund University, SE-251 87 Helsingborg, Sweden. ingela.ahnlide@skane.se.
authors.forename: Ingela
authors.initials: I
authors.lastname: Ahnlide
authors.forename: Kari
authors.initials: K
authors.lastname: Nielsen
authors.forename: Mats
authors.initials: M
authors.lastname: Bjellerup
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003880:Dermatology / Q000379:methods*; D055088:Early Detection of Cancer; D004526:Efficiency; D005260:Female; D006801:Humans; D015994:Incidence; D017492:Keratosis, Seborrheic / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D008875:Middle Aged; D009508:Nevus, Pigmented / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D061366:Numbers Needed To Treat; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012042:Registries; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D019564:Unnecessary Procedures