Melanoma Misdiagnosis More Likely Among Physician’s Assistants: Study

The findings of a new study warn that physician assistants may be more likely to fail to diagnose melanoma than trained dermatologists, raising concerns about the potentially life-threatening form of skin cancer. 

Researchers with the University of Pittsburgh School of Medicine report that physicians assistants were more prone to make a cancer misdiagnosis specifically regarding melanoma, but were just as likely as dermatologists to catch other types of skin cancer or if melanoma was advanced or invasive. The findings were published on April 18 in the medical journal JAMA Dermatology.

The study looked at data from medal records of 33,647 skin cancer screening examinations involving 20,270 unique patients at the university’s dermatology offices from January 1, 2011 to December 31, 2015.

According to the findings, physician assistants (PAs) had to conduct 39.4 biopsies of pigmented lesions to diagnose one case of melanoma. That compared to only 25.4 biopsies needed by dermatologists.

Researchers noted that there were no significant differences when it came to detecting other forms of skin cancer or cases of invasive skin cancer.

“Compared with dermatologists, PAs performed more skin biopsies per case of skin cancer diagnosed and diagnosed fewer melanomas in situ, suggesting that the diagnostic accuracy of PAs may be lower than that of dermatologists,” the researchers concluded. “Although the availability of PAs may help increase access to care and reduce waiting times for appointments, these findings have important implications for the training, appropriate scope of practice, and supervision of PAs and other nonphysician practitioners in dermatology.”

Skin cancer cases in the United States have increased significantly over the past decade, with the number of skin cancer cases in the U.S. reaching more than 260,000 in 2015, costing the U.S. healthcare system hundreds of millions of dollars in related medical costs. Melanoma is the deadliest form of skin cancer.

According to a melanoma diagnosis study published in the Journal of the American Medical Association (JAMA), researchers estimated roughly 80,000 Americans were diagnosed with melanoma in 2016, resulting in at least 10,000 fatalities.

Viagra Melanoma Lawsuits

The study’s findings come as a number of Viagra lawsuits and Cialis lawsuits continue to be filed by men nationwide, alleging that the popular erectile dysfunction drugs caused the development of melanoma.

Viagra (sildenafil citrate) was introduced by Pfizer in 1998, and it has become one of the most widely recognized brand-name medications on the market in the United States, used by millions of men to treat impotence and sexual dysfunction, including the inability to develop or maintain an erection.

Cialis (tadalafil) is a similar erectile dysfunction drug introduced in 2003, which also become a blockbuster treatment amid aggressive direct-to-consumer advertisements.

Since their approval, Viagra and Cialis have been prescribed to an millions of men nationwide. However, recent studies suggest that the medication may reduce the body’s ability to resist the spread of melanoma.

The litigation began to emerge after a study was published in the medical journal JAMA Internal Medicine in April 2014, in which researchers from Harvard Medical School found that men who took Viagra were 84% more likely to be diagnosed with melanoma than men who do not use the drug.

Plaintiffs allege that Pfizer and Eli Lilly knew or should have known about the melanoma skin cancer risk for years, indicating that studies published as early as 2011 suggested that the erectile dysfunction drug may promote melanoma cell invasion. If proper warnings had been provided about the importance of monitoring for skin changes and early signs of melanoma, plaintiffs indicate that they may have been detected melanoma earlier or avoided the disease by avoiding the drugs.