Oral Presentation Skin Cancer 2024

Estimating the magnitude and healthcare costs of melanoma in situ and thin invasive melanoma overdiagnosis in Australia. (#85)

Daniel Lindsay 1 2 , Katy JL Bell 3 , Catherine M Olsen 1 2 , David C Whiteman 1 2 , Thanya Pathirana 4 , Louisa G Collins 1 2 5
  1. QIMR Berghofer, Brisbane, QUEENSLAND, Australia
  2. School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
  3. The University of Sydney, Sydney
  4. Griffith University, Brisbane
  5. Queensland University of Technology, Brisbane

Research suggests a high proportion of melanoma in situ (MIS) may be overdiagnosed, contributing to overtreatment and inflated costs for individuals and healthcare systems. Australia-wide estimates of melanoma overdiagnosis are outdated and no research has quantified costs to the healthcare system. We aimed to estimate the magnitude and cost of overdiagnosed MIS and thin invasive melanomas in Australia. We used routinely collected, national-level data to estimate overdiagnosed MIS and thin invasive melanomas (stage I) in Australia in 2017 and 2021. We multiplied the number of overdiagnosed melanomas by the estimated annual cost of a MIS or thin invasive melanoma to quantify the financial burden of melanoma overdiagnosis to the healthcare system. We estimated that between 67-70% of MIS were overdiagnosed in 2017, rising to 71-76% in 2021, contributing to between 19,829 (95%CI: 19,553 – 20,105) and 20,811 (95%CI: 20,528 – 21,094) overdiagnosed MIS. In 2021, the estimated costs in Australia ranged between $17.7 million (95%CI: $17.4 – 17.9 million) and $18.6 million (95%CI: $18.3 – 18.8 million). We estimated that 22-29% of thin invasive melanomas were overdiagnosed in 2017, rising to 28-34% in 2021. In 2021, the estimated costs from thin invasive melanoma overdiagnoses ranged between $3.1 million (95%CI: $2.9 – 3.2 million) and $5.0 million (95%CI: $4.9 – 5.2 million). Melanoma overdiagnosis is a growing clinical and public health problem in Australia, producing significant economic costs in the year following overdiagnosis. Limiting melanoma overdiagnosis may prevent unnecessary healthcare resource use and improve financial sustainability within the Australian healthcare system.