Skin-Cancer Detection Apps Aren't Reliable

CN Digital StudioCN Digital StudioJoan Kron, Allure magazine

Need to touch up your Facebook photo? As the saying goes, there's an app for that. Worried that the discolored spot on your cheek might turn out to be precancerous? There's an app for that, too-but there's a big difference between the two. One app may get you more "likes" while the other may be meddling-dangerously, it turns out-in a life-or-death health matter.

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Medical apps for smartphones are proliferating, including ones that compare photos of your moles and skin discolorations with a database of known cancers to determine whether your spots are potentially dangerous. In a new study published last week on the website of the journal JAMA Dermatology, the results from four apps designed to assess melanoma risk were found to be disappointing. According to the study's authors, three of those apps tested "misclassified 30 percent or more of melanomas as benign."

The study by members of the dermatology department at the University of Pittsburgh used as samples digital images of 60 skin lesions proven by pathology tests to be melanomas and 128 benign ones. The four apps studied were not identified by name. But the one with the most reliable results has a unique feature: It forwards the photo to an anonymous board-certified dermatologist (i.e., a real human) and returns results within 24 hours. This was also the most expensive of the four apps, charging $5 per image sent.

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None of these apps have FDA approval, and most have disclaimers stating that they are educational tools rather than a substitute for a doctor. But how many people heed disclaimers? Because of the high incidence of misdiagnoses, the authors of the study, Laura Ferris, a dermatologist, and Joel Wolf, a medical student, concluded that diagnostic apps could harm people who use them as a substitute for medical advice.

"This study highlights that you can miss a melanoma diagnosis, and one miss is one too many, because you can die from it," says Mona Gohara, a clinical assistant professor of dermatology at Yale School of Medicine, who has no involvement in the Pittsburgh study. Standard equipment in a dermatologist's office is a dermatoscope that magnifies a spot or mole and can pick up melanomas at an earlier stage. "Caught early, skin cancer can be treated," says Gohara. "If you want a restaurant recommendation, use an app. But for a diagnosis of a medical condition, nothing replaces a doctor."

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