We don’t all need regular skin cancer screening – but you can know your risk and check yourself

Those with fairer skin or a family history may be at greater risk of skin cancer. Halfpoint/Shutterstock^[6]

Why not just do skin checks for everyone?

The goal of screening is to find disease early, before symptoms appear, which helps save lives and reduce morbidity.

But there are a couple of reasons a national screening program is not yet in place.

We need to ask:

1. Does it save lives?

Many researchers would argue this is the goal of universal screening. But while universal skin cancer screening would likely lead to more melanoma diagnoses^[7], this might not necessarily save lives. It could result in indolent (slow-growing) cancers being diagnosed^[8] that might have never caused harm. This is known as “overdiagnosis^[9]”.

Screening^[10] will pick up some cancers people could have safely lived with, if they didn’t know about them. The difficulty is in recognising which cancers are slow-growing and can be safely left alone.

Receiving a diagnosis causes stress and is more likely to lead to additional medical procedures (such as surgeries), which carry their own risks.

2. Is it value for money?

Implementing a nationwide screening program involves significant investment and resources. Its value to the health system would need to be calculated, to ensure this is the best use of resources.

Read more: Yes, you still need to use sunscreen, despite what you’ve heard on TikTok^[11]

Narrower targets for better results

Instead of screening everyone, targeting high-risk groups has shown better results^[12]. This focuses efforts where they’re needed most. Risk factors for skin cancer include fair skin, red hair, a history of sunburns, many moles and/or a family history.

Research^[13] has shown the public would be mostly accepting of a risk-tailored approach to screening for melanoma.

There are moves underway to establish a national targeted skin cancer screening program in Australia, with the government recently pledging $10.3 million^[14] to help tackle “the most common cancer in our sunburnt country, skin cancer” by focusing on those at greater risk.

Currently, Australian clinical practice guidelines recommend doctors properly evaluate all patients for their future risk of melanoma.

Looking with new technological eyes

Technological advances are improving the accuracy of skin cancer diagnosis and risk assessment.

For example, researchers^[15] are investigating 3D total body skin imaging to monitor changes to spots and moles over time.

Artificial intelligence (AI) algorithms^[16] can analyse images of skin lesions, and support doctors’ decision making.

Genetic testing^[17] can now identify risk markers for more personalised screening.

And telehealth has made remote consultations^[18] possible, increasing access to specialists, particularly in rural areas.

Check yourself – 4 things to look for

Skin cancer can affect all skin types, so it’s a good idea to become familiar with your own skin. The Skin Cancer College Australasia has introduced a guide called SCAN your skin^[19], which tells people to look for skin spots or areas that are:

1. sore (scaly, itchy, bleeding, tender) and don’t heal within six weeks

2. changing in size, shape, colour or texture

3. abnormal for you and look different or feel different, or stand out when compared to your other spots and moles

4. new and have appeared on your skin recently. Any new moles or spots should be checked, especially if you are over 40.

If something seems different, make an appointment with your doctor.

You can self-assess your melanoma risk online via the Melanoma Institute Australia^[20] or QIMR Berghofer Medical Research Institute^[21].

Read more https://theconversation.com/we-dont-all-need-regular-skin-cancer-screening-but-you-can-know-your-risk-and-check-yourself-239378

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