You will be presented with the full text of a biomedical research paper. Please write an abstract for this paper. Your response should include the abstract and no additional text.

Paper text:
over the last 10 years , incidence rates of melanoma have increased for both men and women in all age groups , and , according to the united states cancer statistics report , there will be an estimated 65,647 melanoma cases in 2014 [ 1 , 2 ] .
previous studies attributed the increased rates to increased awareness and detection of thin ( 1  mm ) , perhaps less aggressive , lesions [ 35 ] .
however , more recent studies have found a statistically significant increase in incidence for tumors of all varying histological subtypes and thickness , including tumors > 4  mm , indicating that the incidence rates are a true increase [ 6 , 7 ] .
melanoma , along with other cancers ( not including basal or squamous cell carcinomas ) , is mandated by law to be reported by all physicians and treatment facilities to state cancer registries . however , reporting has been particularly challenging . the advent of new techniques such as mohs micrographic surgery and the high percentage of melanomas found to be thin lesions , approximately 70% of invasive melanomas reported to the seer in last decade , have led to decentralization of melanoma management from hospitals to outpatient settings [ 8 , 9 ] . also , given the relative ease of access to the skin , the cycle of care may not involve a hospital , as many dermatologists now utilize outpatient - based dermatopathologists and surgical options .
most of the data compiled by state cancer registries are obtained from hospital cancer registries .
therefore , a lack of or delay in detection of many thin melanomas is likely to occur , resulting in underreporting of early stage melanoma [ 2 , 8 , 11 ] .
generating inaccurate trend estimates on melanoma incidence and burden will undermine efforts to effectively allocate resources and implement public health initiatives .
a survey at a national conference found that 50% of dermatologists were unaware of mandated melanoma reporting and about 56% do not report newly diagnosed cases .
tools to assist the practitioner awareness of methods to report to their state cancer registry may help narrow the knowledge and practice gaps .
the purpose of this study is to generate a cross - sectional snapshot of the various reporting methods available to hospitals , outpatient dermatologists , and outpatient pathology labs for reporting diagnosed melanoma cases to their individual state cancer registries .
also , to investigate the dynamics of available reporting methods , we compared this snapshot to data that we obtained in 2012 .
as this was publicly available information , irb approval was not required . in order to accurately capture various reporting methods available to hospitals , independent pathology laboratories , and nonhospital affiliated physicians
initially , 50 state cancer registry websites were perused for reporting procedures . after this initial investigation
, a brief query was made to every state cancer registry by either email or telephone inquiring about ( 1 ) available electronic reporting methods , ( 2 ) downloadable online reporting forms , and ( 3 ) submission of hard copy pathology reports .
 hospital  here encompasses hospital - based pathology labs and hospital - affiliated physicians .
 pathology labs  and  physicians  refer to independent , non - hospital - affiliated entities . from the information gathered ,
a table of our data was generated depicting various reporting methods available to hospitals , independent pathology labs , and non - hospital - affiliated physicians .
an identical survey that was conducted in 2012 was also perused to observe whether there had been a national shift towards electronic reporting methods for melanoma compared to our current survey .
forty - seven ( 96% ) were equipped for electronic transmission of confirmed melanoma cases from hospitals , pathology laboratories , and physicians ( table 1 ) .
maine and massachusetts were the only 2 states that had yet to implement an electronic method of melanoma reporting ( table 1 ) .
seven ( 14% ) states accepted electronic - only transmittal methods while 40 states ( 82% ) had options for both electronic and nonelectronic reporting methods such as submission of hardcopy pathology reports ( figure 1 ) . for states that allowed nonelectronic reporting , the alternative methods available to mandated reporters included submission of hard copy pathology reports , registries actively requesting pathology reports of diagnosed cases , and allowing reporters to request melanoma reporting forms .
forty - two ( 86% ) state cancer registries permitted submission of hard copy pathology reports ( table 1 )
. twenty - seven ( 55% ) state cancer registries actively requested pathology reports from dermatology practices by sending out periodic surveys ( table 1 ) .
nine ( 18% ) states allowed dermatologists to request melanoma reporting forms directly from them ( table 1 ) , and 22 ( 45% ) states had reporting forms available for download on their registry websites ( table 1 ) .
comparison data exploring shifts in allowable reporting methods showed an increase in electronic reporting methods . in 2012 , 4 state cancer registries had non - electronic - only methods for reporting melanoma . in comparison ,
also , since 2012 , three additional state cancer registries have joined four others in requiring an electronic - only reporting method .
the implementation of the national program of cancer registries ( npcr ) in 1992 signified a push to expand and augment state cancer registries and was a crucial step in developing a system that permitted up - to - date cancer surveillance .
this , in turn , enhanced research efforts to shed light on cancer distribution , population heterogeneity , and environmental etiologies , all required for more efficient resource allocation for education and screening purposes [ 1315 ] . to ensure that these registries obtain accurate and comprehensive data , it is crucial to recognize gaps in data reporting and generate tools targeted at minimizing this gap as much as possible . to address clinician knowledge and practice gaps
, an easy - to - reference table depicting reporting method options may facilitate better data acquisition and thus more robust estimates of melanoma incidence .
we propose that these data be made available on the american academy of dermatology ( aad ) website .
given the mandate of electronic health records , it is natural to expect that all state registries eventually adopt electronic methods for melanoma reporting .
there was a variation in the actual methods each state registry utilized for data transmissions .
some state registries had developed their own software , while , more interestingly , some had implemented the ability for providers eligible for meaningful use stage 2 ( mu-2 ) to report melanoma by transmitting their electronic health records directly to the registries .
this latter method sounds the most feasible and efficient given the ever - increasing administrative burden on physician practices .
however , such a streamlined process faces several challenges given that several facets have yet to be implemented including promotion of physician reporting , on - boarding new providers , and declaration of readiness from state cancer registries .
the comparison data from 2012 and 2014 demonstrated an increased shift towards electronic reporting methods by more state registries ; however this shift is mostly reflective of hospitals and independent pathology labs being able to report electronically .
outpatient dermatologists still do not have the means to report melanoma cases electronically in 11 states ( data not shown ) but we speculate a trend towards mandated electronic reporting from clinicians .
the main limitation of our study is the cross - sectional nature of data collection .
while the purpose was to create a tool depicting state - specific reporting for dermatologists and independent pathology labs , to be most effective , there should be an ongoing , real - time update such that consumers ( dermatologists and pathology labs ) can reference current information .
until such a tool can be developed , depicting our data on the publicly accessible website of a national organization such as aad will hopefully lead to ease of reporting . at the minimum
the goal of our study was to determine current melanoma reporting methods available to dermatologists and dermatopathologists and quantify changes in reporting methods from 2012 to 2014 . 
 a cross - sectional study design was utilized consisting of website perusal of reporting procedures , followed up by telephone and email inquiry of reporting methods from every state cancer registry . 
 this study was conducted over a six - month period from february to august 2014 . 
 a previous similar survey was conducted in 2012 over the same time frame and results were compared . 
 kansas state cancer registry provided no data . as of august 2014 , 96% of 49 state cancer registries had electronic methods available to all designated reporters . 
 seven ( 14% ) states required an electronic - only method of reporting melanoma cases . 
 eighty - six percent allowed hard copy pathology report submission . 
 compared to the 2012 survey , 2 additional states were found to have initiated electronic reporting methods by 2014 . in conclusion , 
 a variety of methods exist for reporting diagnosed melanoma cases . 
 although most state cancer registries were equipped for electronic transmission of cases for mandated reporters , a number of states were ill - equipped for electronic submission from outpatient dermatologists . 
 there was a general trend towards electronic versus nonelectronic reporting from 2012 to 2014 .