Impact of Teledermoscopy on Melanoma Diagnosis and Triage Efficiency in Northern Sweden

TL;DR

Teledermoscopy improved melanoma diagnosis and efficiency in northern Sweden by enabling earlier detection and reducing unnecessary procedures.

Contribution

Demonstrated that teledermoscopy leads to earlier and more efficient melanoma diagnosis in a real-world clinical setting.

Findings

Teledermoscopy reduced mean Breslow thickness of diagnosed melanomas from 1.44 mm to 1.08 mm.

The proportion of thinner melanomas (Breslow ≤ 0.8 mm) increased from 51.4% to 70.6% with teledermoscopy.

The Number Needed to Excise decreased significantly from 23.32 to 9.01 after teledermoscopy implementation.

Abstract

The increasing incidence of cutaneous melanomas requires safe, efficient diagnostic methods to improve patient outcomes while optimizing healthcare resource utilization. Teledermoscopy was incorporated into clinical practice in 2014 in northern Sweden to improve diagnostic accuracy of cutaneous lesions and increase access to specialist dermatology care. This study aimed to evaluate whether teledermoscopy has led to earlier and more efficient diagnostics of cutaneous melanomas. Data on all excised pigmented cutaneous lesions from County Council of Västerbotten analysed at the Department of Clinical Pathology from 2010 to 2019 were collected. Before the introduction of teledermoscopy, the mean Breslow thickness was significantly higher (1.44 mm vs 1.08 mm, p=0.008), the proportion of Breslow ≤ 0.8 mm significantly lower (51.4% vs 70.6%, p< 0.001), and the mean Number Needed to Excise (23.32 vs 9.01, p< 0.001) significantly higher before the introduction of teledermoscopy. This indicates that teledermoscopy contributes to earlier and more efficient melanoma diagnosis.

Malignant melanoma is a serious form of cutaneous cancer, with potentially lethal outcome if not treated in time. Early diagnosis and treatment are crucial for prognosis and survival. Incorporating teledermoscopy into clinical practice, i.e., store-forward pictures enabling evaluation at a distance, has led to more efficient and earlier diagnosis of cutaneous melanomas. This ultimately leads to improved patient outcomes while optimizing healthcare resource utilization.

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