Most new or changed naevi are unlikely to be melanomas, according to Australian researchers. However, a new or changed naevus in an older patient is much more likely to be a melanoma than one in a younger patient. Jeremy Banky and colleagues followed 309 patients (age range, 16-74 years) at high risk for melanoma for an average of nearly 3 years, using baseline photography and dermatoscopy. Overall, 262 new pigmented lesions, 311 changed naevi, 86 completely regressed naevi and 18 melanomas were detected. Patients younger than 50 years of age did have a higher rate of new pigmented lesions and of changed and regressed naevi compared with patients older than 50 years; however, they also had a lower incidence of melanomas. In patients younger than 50 years of age, less than 1% of all new lesions and 3% of changed lesions were melanomas, whereas in patients older than 50 years, 30% of all new lesions and 22% of changed lesions were melanomas.