Equality considerations

Advice

NICE is committed to promoting equality, eliminating unlawful discrimination and fostering good relations between people with particular protected characteristics and others.

Melanoma is more common in older people, with incidence highest in people aged 85 to 89. It is increasing in younger people and is the second most common cancer in adults aged 25 to 49. In younger people, melanoma is more common in women, but it becomes more common in men over 55.

Melanoma is more common in people with white skin because they have less of the protective pigment melanin. People with black or brown skin are more likely to be diagnosed with advanced melanoma. Late diagnosis of melanoma is associated with worse outcomes and a higher risk of death. There are considerations needed with artificial intelligence (AI) technologies for detecting melanoma in terms of transparency of reporting the training data used to inform the system. The evidence base reports on skin types using the Fitzpatrick scale, which has 6 main skin types (type 1: always burns, never tans; type 2: usually burns, tans minimally; type 3: sometimes burns mildly, tans uniformly; type 4: burns minimally, tans easily; type 5: very rarely burns, tans very easily; type 6: never burns, tans very easily). The training data must reflect the diversity of the population in which it will be used and therefore must demonstrate evidence of accurate performance across all skin types (Food and Drug Administration's AI and machine learning in medical devices, 2020; British Association of Dermatologists' position statement 2022). This will ensure that this technology will not contribute to inequitable access to healthcare. Age and race are protected characteristics under the Equality Act 2010.