Should You Be Screened for Melanoma?

Should You Be Screened for Melanoma?

New skin-cancer-screening recommendations 

might have you confused

Consumer Reports / Julia Calderone  / July 26, 2016 / www.consumerreports.org

You might think that with all the concerns about melanoma, the benefits of having your skin checked every year by a doctor for skin cancer would be clear. But it isn't.

The U.S. Preventive Services Task Force, an independent group that advises the government on public health issues, just released its latest analysis on skin cancer research.

After analyzing the abstracts and text of about 13,000 studies going back 20 years, they narrowed it down to 13 to include in the review. Their conclusion: There's not enough evidence to say that regular professional skin checks save lives, or to recommend for, or against, routine checks. That's the same conclusion the Task Force reached back in 2009, the last time it did a comprehensive review of the research.

Does that mean that you skip the exams? No. David C. Grossman, M.D., the vice chair of the Task Force and a senior investigator at the Group Health Research Institute Group Health in Seattle, says that in the absence of clear benefits (or harms), the decision depends largely on you and your doctor's assessments of your personal risk.

Our medical experts agree, and stress that the Task Force's review didn't look at people at high risk, or assess the benefits of seeing a dermatologist instead of a primary care provider. It also did not evaluate the effectiveness of self-examinations.

"The greater your risk of skin cancer, the more important regular skin checks, preferably by a dermatologist, becomes," says Jessica Krant, M.D., a clinical assistant professor of dermatology at SUNY Downstate Medical Center in Brooklyn, N.Y., and a member of Consumer Reports’ medical advisory board.

In addition, the Task Force's inconclusive take on professional skin cancer screenings underscores the importance of you taking an active role in preventing the cancer and catching it early. That means taking steps to avoid the UV radiation that can cause skin cancer, and also periodically checking your own skin, so you notice when worrisome changes appear.

Here why skin cancer is such a concern, and what you should consider as you determine when and how often you should have your skin checked.

Know Your Risks

The number of people developing and dying from melanoma has risen steadily for the last 30 years, according to the American Cancer Society. About 10,000 Americans each year now die of the disease, and some 76,000 are diagnosed with it. More than 5 million other people develop basal and squamous cell cancers, two of the more common but less deadly types of skin cancer.

Melanoma can appear suddenly and spread quickly, making it important to catch it early.

For that reason, our medical experts say it is important that you be aware of changes on your skin, and to contact your doctor if you see any worrisome shifts. A 2009 study in the journal Archives of Dermatology found that 44 percent of melanomas were discovered by patients. Look especially for skin lesions that are asymmetrical, have irregular or ragged borders, are multicolored, are larger than a pencil eraser in diameter, or are changing over time. Find out how to spot melanoma.

In addition, you should get a skin check, at least every year if you are at high risk of skin cancer, Krant says. Preferably, that doctor should be a dermatologist. Their advanced training makes them better able to identify worrisome lesions, which means that they are less likely to overlook dangerous melanomas and refer you to needless biopsies.

Factors that increase your risk of skin cancer include:
• a history of sunburns;
• fair skin, light eyes, or red or blond hair;
• a family history of melanoma; and
• a personal history of basal cell or squamous cell cancer.  

Even if you are at lower risk you should still periodically have your skin checked by a physician; consider asking for a referral to a dermatologist for the exam.

Prevention is Key

Not all skin cancers can be prevented by avoiding UV rays. Genetics play a strong role in the cancer, and you can develop the malignancy even on parts of the body that rarely see the sun.

Still, taking steps to avoid radiation can cut your risk of developing the disease. One simple step: Avoidindoor tanning. Experts estimate that it causes a 450,000 new skin cancer cases each year, of which 10,000 are melanomas.

It also pays to limit your exposure to the sun’s damaging rays. Spending less time directly in the sun, especially between 12 noon and 3 p.m. is one of the most important things you can do, Grossman says.

And when you are out in the sun, wear a broad-rimmed hat and protective clothing when you can, and use sunscreen all the time. Here's how to make sure you apply sunscreen correctly.

www.consumerreports.org