We would like to thank Rigel et al for their comments. It is unfortunate that they have elected to address what they say we "implied" rather than what we actually wrote.1 Our key points remain essentially unchallenged and unfortunately unaddressed: increases in the incidence of melanoma may in large part be explained by the culling of thin melanomas from relatively small populations who have experienced increased surveillance (which is not the same as screening), while no commensurate increase in advanced lesions and death have been noted in groups not the target of heightened scrutiny, and there is an inherent inability of microscopic examination to render verifiable and consistent predictive information when applied to these
Swerlick RA, Chen S. Melanoma Incidence: If It Quacks Like a Duck.-Reply. Arch Dermatol. 1997;133(5):658–659. doi:10.1001/archderm.1997.03890410120023
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