{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T01:54:22Z","timestamp":1790733262958,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,11,7]],"date-time":"2022-11-07T00:00:00Z","timestamp":1667779200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Evidence exists that escalating melanoma incidence is due in part to overdiagnosis, the diagnosis of lesions that will not lead to symptoms or death. The authors aimed to characterize subsets of melanoma patients with very\u2010low risk of death that may be contributing to overdiagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Melanoma patients diagnosed in 2010 and 2011 with stage I lesions \u22641.0\u00a0mm thick and negative clinical lymph nodes from the Surveillance, Epidemiology, and End Results database were selected. Classification and regression tree and logistic regression models were developed and validated to identify patients with very\u2010low risk of death from melanoma within 7\u00a0years. Logistic models were also used to identify patients at higher risk of death among this group of stage I patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to an overall 7\u2010year mortality from melanoma of 2.5% in these patients, a subset comprising 25% had a risk below 1%. Younger age at diagnosis and Clark level II were associated with low risk of death in all models. Breslow thickness below 0.4\u00a0mm, absence of mitogenicity, absence of ulceration, and female sex were also associated with lower mortality. A small subset of high\u2010risk patients with &gt;20% risk of death was also identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients with very\u2010low risk of dying from melanoma within 7\u00a0years of diagnosis were identified. Such cases warrant further study and consensus discussion to develop classification criteria, with the potential to be categorized using an alternative term such as \u201cmelanocytic neoplasms of low malignant potential.\u201d<\/jats:p><\/jats:sec><jats:sec><jats:title>Lay summary<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Although melanoma is the most serious skin cancer, most melanoma patients have high chances of survival.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>There is evidence that some lesions diagnosed as melanoma would never have caused symptoms or death, a phenomenon known as overdiagnosis.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>In this study, we used cancer registry data to identify a subset of early\u2010stage melanoma patients with almost no melanoma deaths.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Using two statistical approaches, we identified patients with &lt;1% risk of dying from melanoma in 7 years.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Such patients tended to be younger with minimal invasion into the skin.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>We also identified a very small patient subset with higher mortality risk.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.34490","type":"journal-article","created":{"date-parts":[[2022,11,7]],"date-time":"2022-11-07T03:01:28Z","timestamp":1667790088000},"page":"89-97","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Prognostic modeling of cutaneous melanoma stage I patients using cancer registry data identifies subsets with very\u2010low melanoma mortality"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0485-077X","authenticated-orcid":false,"given":"Megan M.","family":"Eguchi","sequence":"first","affiliation":[{"name":"Department of Medicine 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