What to Expect During a Skin Cancer Screening

May 31, 2022
ASCO Staff

Skin cancer screening is used to detect cancer at an early stage, which is when the chance of a cure is high. Doctors may recommend this type of cancer screening for people who have a higher risk for skin cancer, including people who have many moles, irregular moles, or a personal or family history of skin cancer.

If you are curious about whether you should be getting regularly screened for skin cancer, ask your health care team. They may recommend seeing a dermatologist or other health care provider to examine your skin more closely. Here, find out the basics of skin cancer, what you can expect during a skin cancer screening, and how you can lower your risk for developing skin cancer.

How common is skin cancer?

Skin cancer is the most commonly diagnosed cancer in the United States and around the world, according to the Skin Cancer Foundation. The 3 most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma, and melanoma. Together, basal cell carcinoma and squamous cell carcinoma are called keratinocyte carcinomas, or non-melanoma skin cancer. Melanoma is the most dangerous type of skin cancer.

Non-melanoma skin cancer is more common than melanoma. It is estimated that 5.4 million cases of basal cell carcinoma and squamous cell carcinoma are diagnosed annually in the United States among 3.3 million people, according to the American Cancer Society. Melanoma will be diagnosed in about 100,000 Americans this year.

What is the purpose of skin cancer screening?

The goal of screening is to detect skin cancer while it is small and confined to the skin, when the chance of a cure is higher. Skin cancer screening can be done by looking at your own body as part of a self-examination, or by visiting a health care professional like a dermatologist to have your skin examined.

Skin cancers are highly treatable if detected early, according to the American Academy of Dermatology. For instance, many people with melanoma are cured by their initial surgery.

What are the risk factors for skin cancer?

Factors that increase skin cancer risk include:

  • Having many moles

  • Having moles that look different from other moles in color or shape

  • Having a personal or family history of skin cancer

  • Previous indoor tanning use

  • Severe sun damage

  • Having fair skin, blond or red hair, blue eyes, and freckles

  • Having a weakened or suppressed immune system

People who have any of these risk factors should talk about their risk level for skin cancer with their doctor and consider seeing a dermatologist for an initial skin cancer screening. Age is also a factor your dermatologist will consider when they recommend a schedule for regular follow-up exams.

While anyone can get skin cancer, it is considerably more prevalent in people who are White compared to people who are Black, Hispanic, or Asian. However, people of color are more likely to be diagnosed with skin cancer at an advanced stage when the cancer is more difficult to treat, and they have a higher risk of dying after their diagnosis, according to a 2016 study.

If you notice any abnormal changes on your skin that are new, changing, or uncomfortable, or have wounds that won’t heal, make an appointment with a dermatologist right away. The American Academy of Dermatology has an online directory where you can find a dermatologist near you, or you can ask your primary care doctor for a referral.

What can you expect during a skin cancer screening?

During a skin cancer screening, the doctor will look at your skin from head to toe. This includes your scalp and between your fingers and toes. If you’ve noticed any moles or other lesions that are new, changing, or causing symptoms like itching or pain, tell your doctor so that area can be examined closely.

The doctor will also examine lesions that look different from others, including ones that have irregular borders, multiple colors, or are bigger than 6 millimeters (mm) in diameter. They might use a dermatoscope to inspect individual lesions. A dermatoscope is a handheld device that allows the doctor to evaluate an area of the skin much more closely.

As part of the screening, your doctor may recommend a biopsy, which involves taking a sample of skin to test for cancer. It takes a few minutes to perform this type of biopsy, and the biopsy wound should heal in 1 to 2 weeks. The doctor then sends the biopsy sample to a lab for testing, and you will receive the results from your doctor in a week or 2 after that. If cancer has been found, your doctor will arrange for additional treatment, such as surgery. If the skin cancer is more advanced or if there is evidence that the cancer has spread to other areas of the body, then your doctor will refer you to an oncologist for further treatment.

“Fortunately, most new, changing, symptomatic, atypical, or outlier lesions are not cancer,” says Ashfaq Marghoob, MD, director of clinical dermatology at Memorial Sloan Kettering Cancer Center in New York City.

How often is skin cancer screening done?

If your doctor recommends regular skin cancer screenings for you, how often it will be done depends on which risk factors you have, including your age, your number of moles, your number of complex or atypical moles, your own history of melanoma, and your family history of skin cancer. Doctors can recommend a screening every year or even every 3 or 6 months if someone is at particularly high risk. Talk with your doctor about what screening schedule is most appropriate for you.

How can you prevent skin cancer?

The best way to prevent skin cancer is to protect your skin from the sun and its ultraviolet (UV) radiation. When outside, try to avoid sun exposure between the hours of 10 a.m. and 4 p.m. If you are outside in the sun, be sure to cover exposed skin with clothes, a hat, and sunglasses, and apply a broad-spectrum sunscreen to uncovered areas with a sun protection factor (SPF) of 30 or higher. You should also avoid outdoor sunbathing or using an indoor tanning bed.

Finally, examine your skin regularly for any new moles or lesions or changes in existing moles.

It may be helpful to remember the alphabetical “ABCDE rule” to watch for the warning signs of melanoma in moles:

  • A: Asymmetrical, meaning the mole is misshapen

  • B: Borders that are uneven or with notches or scallops

  • C: Colors such as brown, tan, or black inside a mole

  • D: Diameter greater than 6 mm

  • E: Evolving in size, shape, color, or elevation

If you notice any changes, make an appointment with your dermatologist to have it evaluated right away.

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