Impact of skin biopsy practices: A comprehensive nationwide study on skin cancer and melanoma biopsies.

Cohort studyJournal of the European Academy of Dermatology and Venereology : JEADV· Jul 2025

Impact of skin biopsy practices: A comprehensive nationwide study on skin cancer and melanoma biopsies.

G G Nervil, T Vestergaard, S Klausen … L R Hölmich

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DermatopathologyCohort studyClinical practiceQ1IF 3.1

Clinical suspicion of skin cancer sharply lowers benign-to-malignant biopsy ratio

Impact of skin biopsy practices: A comprehensive nationwide study on skin cancer and melanoma biopsies.

G G Nervil … L R Hölmich

Journal of the European Academy of Dermatology and Venereology · Jul 2025

Background

Due to a multitude of factors, skin cancer incidence is increasing and challenges medical professionals in biopsy decision-making.

Purpose

It aims to determine the benign to malignant ratio (benign to malignant ratio) and number needed to biopsy (number needed to biopsy) and estimate the direct cost of benign skin lesion biopsies in the Cancer Pathway from the perspective of a public healthcare system.

Methods

The study included 4,481,207 biopsy specimens from January 2007 to June 2022 from the Danish Pathology Data Bank, of which 151,988 from the Cancer Pathway were included in the primary analysis of benign to malignant ratio.

n = 4,481,207 biopsy specimens

Results

Only 1.5 benign biopsies per malignant one when biopsied on cancer suspicion, versus 4.1:1 overall

4.1BMR (b

Overall BMR

1.5BMR (b

BMR on clinical suspic

More results

The number of biopsies increased by 39.1% from 2007 to 2021.

The cost of benign skin biopsies performed on suspicion of cancer or melanoma in 2021 was €6.6M, predominantly in hospitals.

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Conclusion · 1 of 2

A healthcare system that employs filtering functions before biopsy of skin lesions can achieve some of the lowest benign to malignant ratio reported in the world, but with most benign skin lesion excisions due to suspicion of malignancy performed in the expensive hospital setting.

Conclusion · 2 of 2

Including clinical reason for biopsy in diagnostic accuracy studies using number needed to biopsy is crucial.

Impact of skin biopsy practices: A comprehensive nationwide study on skin cancer and melanoma biopsies.

Impact of skin biopsy practices: A comprehensive nationwide study on skin cancer and melanoma biopsies.

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