Important New Information About Skin Cancer Screenings

All summer long, we are constantly reminded to lather up to reduce the risk of sunburn or skin cancer. But on a clinical level, should you be doing anything more than meticulously applying sunscreen and adequately hydrating yourself? Turns out, the answer is no.

Related Content: Practice Safe Sun

The US Preventive Services Task Force updated the screening for skin cancer last week for the first time since 2001 and explicitly stated that current evidence is insufficient to assess the balance of benefits and harms of visual skin examination by a clinician to screen for skin cancer in adults. Essentially, the USPS Task Force is saying that performing regular full body scans or harping on the details of a semi-suspicious lesion found on a physical exam can result in a high rate of unnecessary biopsies, cosmetic adverse effects and over-diagnosing or over-treating a lesion.

The important thing to remember is the type of skin lesion being assessed. Skin cancer means you have either a melanoma or a non-melanoma lesion. Non-melanomas are further divided into a basal cell carcinoma or a squamous cell carcinoma.
Melanomas are generally much more malignant and aggressive cancers than squamous cell carcinomas or basal cell carcinomas. Melanomas tend to be irregularly shaped and highly pigmented lesions that can seep into the underlying bloodstream relative quickly. Squamous cell carcinomas (non-melanoma) occur most commonly on areas with heavy sunlight exposure and look like rough reddish lesions. Basal cell carcinomas (non-melanoma) look like a fleshy or waxy mole that just never seems to go away.
In 2016, an estimated 76,400 adults in the US will develop melanoma and 10,100 will die from this disease. Less than 0.1% of patient deaths are caused by non-melanomas, which is why the USPS task force explains that aggressively diagnosing and treating a skin lesion that is not entirely reminiscent of a basal cell carcinoma or a squamous cell carcinoma can do more harm than good.

Do you know a melanoma when you see one? You can. Every dermatologist assesses the lethality of a lesion using an A, B, C, D and E screening: Asymmetry, Border, Color, Depth, Evolution. Varying sizes, shapes and colors can be more telling for a malignant lesion vs. a non-malignant one.

The best bet is to keep practicing safe sun tips as we’ve discussed before, and people with more fair skin or a family history of skin cancer should always be more cautious.

dr. uruj kamal

dr. uruj kamal

Dr. Uruj Kamal is Chief Resident of Adult Outpatient Psychiatry at Baystate Medical Center-University of Massachusetts Medical School. A Stony Brook native, she enjoys combining her knowledge of mental health with healthy living. Dr. Kamal has a special interest in outpatient adult psychiatry.