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Mind the Gap: Impact of New Labels on Public Perceptions and Calculated Risk of Adverse Outcomes after a Melanoma In Situ Diagnosis—A Secondary Analysis of an Online Randomized Experiment

Author

Listed:
  • Zhuohan Wu

    (Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
    Wiser Healthcare Research Collaboration, Sydney, NSW, Australia)

  • Farzaneh Boroumand

    (Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
    Centre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia)

  • Brooke Nickel

    (Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
    Wiser Healthcare Research Collaboration, Sydney, NSW, Australia)

  • Adewole S. Adamson

    (Department of Internal Medicine (Division of Dermatology), The University of Texas at Austin Dell Medical School, Austin, TX, USA)

  • Lisa Parker

    (Northern Clinical School, Faculty of Medicine & Health, Charles Perkins Centre, University of Sydney, Australia
    Department of Radiation Oncology, Royal North Shore Hospital, Sydney, Australia)

  • Elspeth Davies

    (Patient Advocate and Senior Researcher at the University of Oxford, Oxford, UK)

  • Katy J. L. Bell

    (Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
    Wiser Healthcare Research Collaboration, Sydney, NSW, Australia)

Abstract

Background. Alternative diagnostic labels for melanoma in situ may better reflect its lower risk (15-y survival of 98%) compared with invasive melanoma (10-y survival ranging from 98% for American Joint Committee on Cancer stage IA to 19% for stage IV). Design. Secondary analysis of an online randomized experiment in Australian adults without melanoma. Participants were randomized to a hypothetical diagnosis of “melanoma in situ (MIS)†(control), “low-risk melanocytic neoplasm,†or “low-risk melanocytic neoplasm, in situ†and completed a survey. Outcomes. Perceived risk measures were future invasive melanoma and mortality risk (0%–100%), comparative risk, affective risk, and vulnerability (7-point Likert scales). Calculated risk measures were lifetime invasive melanoma risk (from participants’ risk factors) and melanoma mortality probability (Australian sex-/age-specific mortality rates). Analysis. An intention-to-treat analysis across randomized groups was performed, unadjusted and adjusted for covariates (linear regression models). Results. In total, 1,668 adults were recruited. Compared with MIS, perceived melanoma mortality risk was lower for low-risk melanocytic neoplasm (−10.4%, 95% confidence interval [CI]: −13.1% to −7.63%, P  

Suggested Citation

  • Zhuohan Wu & Farzaneh Boroumand & Brooke Nickel & Adewole S. Adamson & Lisa Parker & Elspeth Davies & Katy J. L. Bell, 2026. "Mind the Gap: Impact of New Labels on Public Perceptions and Calculated Risk of Adverse Outcomes after a Melanoma In Situ Diagnosis—A Secondary Analysis of an Online Randomized Experiment," Medical Decision Making, , vol. 46(6), pages 780-794, August.
    • Handle: RePEc:sae:medema:v:46:y:2026:i:6:p:780-794
    DOI: 10.1177/0272989X261446536
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