Skin cancer screening

A friend or family member gets diagnosed with skin cancer — and now you want to get checked! This article will review who, what, where, why, and how to get a skin cancer screening.

Who needs a skin cancer screening? When should you get one? And why?

Anyone who wants one at anytime.

According to the Skin Cancer Foundation, more people in the US are diagnosed with skin cancer than any other cancer combined. Skin cancers when caught early is very treatable, and curable.

However, the U.S. Preventive Services Task Force (USPSTF) concluded that there is currently not enough evidence for or against routine skin cancer screenings for people who do not have a history of skin cancer or any suspicious lesions. Though, if you have a suspicious lesion, it is recommended to come in for a screening!

Skin cancer screenings are recommended for those who have personal risk factors such as a family or personal history of skin cancer (non-melanoma skin cancers (NMSCs) or melanoma), history of tanning bed use, history of multiple sunburns, any changing skin lesion (new, growing, bleeding), history of transplant, and history of immunosuppression (ie. taking medications that lower your immune system). Depending on your risk factors, your dermatologist may recommend getting checked either every 3 months, 6 months, 1 year, or as needed (ie. when something new pops up!).

Of note, just one indoor tanning session can increase the risk of developing skin cancer (melanoma by 20%, squamous cell carcinoma by 67%, basal cell carcinoma by 29%).

Early detection is key. Skin cancers are curable. There is very little diseases in medication that we can actually cure. Once the skin cancer is cut out, there is <1% chance that it will recur. For example, the 5-year survival rate for melanoma is 99% if diagnosed early. If diagnosed late, survival drops precipitously. This can mean the difference between life and death.

What is a skin cancer screening? Where can you get one?

A skin cancer screening can be done by your primary care doctor during your annual physical exam. However, for those with risk factors, it may be a better idea to get it done by a Board-Certified Dermatologist. A dermatologist has the training to look at all spots on the skin and find suspicious lesions early. Usually, dermatologists carry a dermatoscope (a big magnifying glass with a polarized light). This allows the dermatologist to recognize suspicious patterns in the skin; once identified, they may suggest a skin biopsy to confirm if it is indeed a skin cancer or not.

Below are the steps to a skin examination:

  1. The doctor’s assistant will likely ask you to get into a gown with only your undies on. This will help the doctor easily check every area of your ski. [If you prefer a doctor of a specific gender, request it at the time of your appointment scheduling. Always ask if you prefer to have a chaperone in the room.]
  2. You will lay down on a bed, usually face up, then flip over onto your belly, face down. This will allow the doctor to look at each side of your body thoroughly. [If you have a disability or in a wheelchair, these steps may be difficult to perform; the doctor may have to do your skin check while you are in your wheelchair.]
  3. The doctor may point out different skin spots during their examination; if you have a question about a specific spot, ask them.
  4. As you get older, there may be new benign spots that pop up, like red bumps (ie. cherry angiomas) or brown scaly growths (ie. seborrheic keratoses). Usually these can be identified easily by your doctor. Insurance usually does not cover for the removal of benign lesions. If you wish to get them removed, ask your doctor about ways to cosmetically remove these spots.
  5. If the doctor identifies a specific lesion to biopsy, they will tell you what type of biopsy they will do i.e tangential skin biopsy, punch skin biopsy, or excisional skin biopsy. Depending on the type of biopsy, the doctor may have to put in sutures.
  6. If you do not wish for a biopsy at the time, the doctor may take a photo and ask you come back sooner than later to see if the lesion has grown over time. Anything that grows over time is concerning and may require a biopsy.
  7. Once the examination is complete, the doctor will then suggest you come back for another skin check in a specific time frame. Please come to your appointments as recommended.
  8. Remember, prevention is key. Please wear your sunscreen and sun protective clothing/gear at all times to prevent skin cancer.

Note, not all doctors’ offices can address a full skin cancer screening and other skin related concerns at one time, so call ahead to let your doctor’s office know so that they can either schedule 2 separate appointments or schedule enough time for your visit to address all of your concerns. 

In summary, ask your insurance to see if you have coverage for a skin cancer screening, and call your own dermatologist for a visit. Even if you don’t have coverage, skin cancer screenings are available to anyone, you may just have to pay out of pocket. If there is a changing, growing, bleeding lesion on your skin, come in right away to get it checked, don’t wait. Don’t forget to wear sunscreen and reapply every 2 hours to protect your skin from damaging UV rays which may contribute to the development of skin cancers over time. My youngest patient who has had a skin cancer is age 19, so it’s never too early to get checked.

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