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Participants were randomized to a hypothetical diagnosis of \u201cmelanoma in situ (MIS)\u201d (control), \u201clow-risk melanocytic neoplasm,\u201d or \u201clow-risk melanocytic neoplasm, in situ\u201d and completed a survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes.<\/jats:title>\n                    <jats:p>Perceived risk measures were future invasive melanoma and mortality risk (0%\u2013100%), comparative risk, affective risk, and vulnerability (7-point Likert scales). Calculated risk measures were lifetime invasive melanoma risk (from participants\u2019 risk factors) and melanoma mortality probability (Australian sex-\/age-specific mortality rates).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Analysis.<\/jats:title>\n                    <jats:p>An intention-to-treat analysis across randomized groups was performed, unadjusted and adjusted for covariates (linear regression models).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results.<\/jats:title>\n                    <jats:p>\n                      In total, 1,668 adults were recruited. Compared with MIS, perceived melanoma mortality risk was lower for low-risk melanocytic neoplasm (\u221210.4%, 95% confidence interval [CI]: \u221213.1% to \u22127.63%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u20090.001) and for low-risk melanocytic neoplasm, in situ (\u22127.4%, 95% CI: \u221210.2% to \u22124.6%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Similar patterns were observed for perceived risk of invasive melanoma; comparative, affective risk; and vulnerability. Participants in all groups substantially overestimated their lifetime risk of invasive melanoma (by 48.7%) and of dying from melanoma (by 32.0%) compared with the calculated risk; overestimation was lower in alternative label groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions.<\/jats:title>\n                    <jats:p>Diagnostic labels without the word \u201cmelanoma\u201d reduced risk overestimation, supporting MIS relabeling to mitigate overdiagnosis harm by reflecting its largely indolent nature.<\/jats:p>\n                    <jats:p>Trial registration: ANZCTR: 386943<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>Alternative diagnostic labels for melanoma in situ that do not include the word \u201cmelanoma\u201d significantly decreased perceived risk compared with melanoma in situ.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Participants substantially overestimated their risk; alternative labels reduced this overestimation of perceived risk compared with calculated risk.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>A new label for melanoma in situ may better communicate the lower risk of adverse outcomes for this lesion compared with invasive melanoma. This may reduce patient anxiety and allow for management decisions that align with their values and preferences.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:sec>","DOI":"10.1177\/0272989x261446536","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T04:05:37Z","timestamp":1781496337000},"page":"780-794","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Mind the Gap: Impact of New Labels on Public Perceptions and Calculated Risk of Adverse Outcomes after a Melanoma In Situ Diagnosis\u2014A Secondary Analysis of an Online Randomized Experiment"],"prefix":"10.1177","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1281-3449","authenticated-orcid":false,"given":"Zhuohan","family":"Wu","sequence":"first","affiliation":[{"name":"Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia"},{"name":"Wiser Healthcare Research Collaboration, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farzaneh","family":"Boroumand","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia"},{"name":"Centre for Kidney Research, The Children\u2019s Hospital at Westmead, Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8100-4278","authenticated-orcid":false,"given":"Brooke","family":"Nickel","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia"},{"name":"Wiser Healthcare Research Collaboration, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adewole S.","family":"Adamson","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine (Division of Dermatology), The University of Texas at Austin Dell Medical School, Austin, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Parker","sequence":"additional","affiliation":[{"name":"Northern Clinical School, Faculty of Medicine &amp; Health, Charles Perkins Centre, University of Sydney, Australia"},{"name":"Department of Radiation Oncology, Royal North Shore Hospital, Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elspeth","family":"Davies","sequence":"additional","affiliation":[{"name":"Patient Advocate and Senior Researcher at the University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0137-3218","authenticated-orcid":false,"given":"Katy J. 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