Australia has the highest rate of skin cancer in the world. By the age of 70, nearly two-thirds of the Australians will be diagnosed with this cancer. The vast majority are non-melanoma skin cancers like basal cell carcinoma and squamous cell carcinomas. They are easy to treat and really they spread to other body parts. 30 years of SunSmart campaigns have helped to raise community awareness about skin cancer. But as most people know early detection is the best there is confusion about whether to go for regular skin checks to Skin Cancer Experts. Breast, cervical and bowel cancer prevention programs recommend people with mammography, stool tests and Pap tests, but this is not the case for skin cancer check.
Recent clinical guidelines recommend to examine your own scale and ask your GP for a skin check if you notice something suspicious. This means to familiarise yourself with the skin and look for new lumps, moles, legions or sources or those that have changed shape colour or size. There is very less evidence that checking everybody could save lives because –
- Very few people die from non – Melanoma skin cancer
- Advanced stage Melanoma is fatal, the frequency of occurrence of Melanoma doesn’t justify on economic grounds, a mass screening program.
- The instrument to be used for mass screening is not accurate enough, GPs can remove many benign lesions and are unable to diagnose or remove cancer.
What Should You Do If You Find A Suspicious Spot?
If you find a suspicious spot on the skin, ask your GP for a skin check. Your family doctor knows your medical history and your family history and should be the first person to call. The doctor can make only three possible diagnoses for your skin lesion, clearly benign, clearly malignant and too close to call. If the doctor is sure the lesion is skin cancer they will suggest you get it removed. Each GP knows their surgical skill limits and refers you to a Dermatologist. If you are concerned about scaring you may request a referral to a dermatologist or a plastic surgeon. If the doctor is sure that the lesion is benign, no treatment is needed. He will examine any other skin lesions and provide you with advice regarding sun protection and early diagnosis of skin cancer.
If after examining your skin, the doctor is 99% sure that the lesion is benign, then a definite diagnosis is required. The options are excision biopsy, Diagnostic biopsy, or reference to a dermatologist. Specialist access varies and the patient needs to wait for weeks or months for a definitive detection. So GPs excise lesions which they feel are at low risk. The amount of benign lesions required to be excised for any skin cancer removed is 20 for Melanoma and 3 for non-melanoma skin cancers. Some Dermatologist centres offer quick assessment clinics for GP referred people with suspicious lesions.
People at high risk of skin cancer can benefit from asking the doctor for a skin check. Apart from facilitating early diagnosis on the skin check gives an opportunity to discuss your risk, what to look for when examining the skin and ways to protect yourself in the sun. Medical photography is popular and there is some evidence to support its use in high-risk patients to detect melanomas early. Photographs are not the best way to detect non-melanoma skin cancers. Nor are they substitutes for an examination by an experienced doctor.
People who had previous cancer should visit their Dermatologist once a year for a skin check. Those people who have more than 20 solar keratosis treatments should consult a Dermatologist for an initial assessment and then once in every two or three years. People with the first-degree relative who suffered a Melanoma should request their GP for a skin check and to assess the risk cost of those with fair skin, Blue Eyes, red hair and with lots of moles should go for a skin check once they hit 30. People with blonde hair, blue eyes and fair skin should wait until they are 40 and the rest might consider having a check when they turn 50.