AI Article Synopsis
- Cutaneous melanoma (CM) is often underreported to cancer registries, particularly in nonhospital settings, prompting a study on the influence of dermatologists and pathology labs on CM reporting rates.
- Over nearly four decades, the State Health Registry of Iowa documented over 22,000 CM cases, with a notable 3.6-fold increase in invasive melanoma incidence from 1973 to 2011, highlighting the importance of private reporting in reflecting true incidence.
- The findings suggested that better electronic reporting systems could enhance CM case tracking, especially considering that nonhospital reports primarily came from urban areas, revealing a shift in case characteristics over time, such as age at diagnosis and the ratio of invasive to in situ cases.
Article Abstract
Background: Cutaneous melanoma (CM) is underreported to cancer registries, in part due to insufficient reporting in the nonhospital setting. The objective of this study was to better understand the impact of dermatologist and private pathology laboratory reporting on CM rates.
Methods: We examined the impact of targeted casefinding in private pathology laboratories and dermatology offices by the State Health Registry of Iowa (SHRI) on CM incidence, as well as the characteristics of nonhospital reported cases.
Results: Over the 39-year period (1973-2011), 22,541 cases of CM were captured by the SHRI; 16,183 (72%) were invasive melanoma cases and 6,358 (28%) were in situ cases. The incidence of invasive melanoma increased 3.6 fold between the time periods of 1973-1975 and 2009-2011 (6.6 vs. 24 per 100,000 person-years, respectively). If case reporting from private pathology laboratories and dermatology offices was not conducted, the 2009-2011 invasive CM rate would have decreased to 19.1. The ratio of invasive to in situ cases declined from 8:1 from 1973-1987 to less 2:1 from 2007-2011. Age at diagnosis also significantly increased across time periods, while the proportion of females declined. From 2007-2011, the majority (55%) of nonhospital cases were in situ, and 90% of the invasive cases were localized. A higher percentage of urban residents were attributed to nonhospital-based reporting sources compared to hospital-based sources (57% vs 45%, P < .0001) CONCLUSIONS: Electronic health records and incentivized Meaningful Use for reporting may provide an efficient method for nonhospital based providers to easily and accurately report CM cases to registries.
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