Wait, What? Skin Cancer Checks May Not Be Worth the Trouble?

woman getting skin check

So here's a head-scratcher. After YEARS of dermatologists urging us to have an annual skin check, where you're checked head to toe (literally) for signs of skin cancer, a new expert medical panel's all like, "You know what? Never mind. You don't need 'em."

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The federally appointed US Preventive Services Task Force (try saying that five times fast) recently gave visual skin screenings a rating of "I."

"I" NOT meaning "Indispensable."

"I" meaning "insufficient evidence to weigh the potential benefits against possible harms."

Wait, what?

We are SO confused. Over the past three decades, more people have had skin cancer than any other cancers combined.

So ... isn't early detection KEY to surviving melanoma? (Answer: yes.)

And although you're supposed to check for suspicious moles and lesions EVERYWHERE on your body each month, how on earth are you supposed to see, say, the tip-top of your scalp or the small of your back?

CafeMom asked Mark Faries, MD, surgical oncologist and director of the Donald L. Morton, MD, Melanoma Research Program, as well as the director of therapeutic immunology at the John Wayne Cancer Institute at Providence Saint John's Health Center in Santa Monica, California, to explain WTF.

What on earth is behind the panel's recommendation to skip screenings?
The Task Force is supposed to examine screening procedures like mammograms and determine if there's sufficient evidence to recommend them. They don't consider expert opinion or common sense as evidence, but only seem to be satisfied by clinical trials to show that a screening test should be done. 

In recent years, there's been a pendulum swinging away from screening procedures or tests. In many instances, this is due, in part, to a concern that the test may be causing harm, due to cost or exposure to radiation (for scans), or the cost or toxicity ... isn't actually helpful to patients.

With skin cancer, these arguments don't make much sense. The "test" is a thorough physical exam. This costs no more than any other doctor's visit and exposes the patient to no radiation or needles.

So will this new recommendation change how doctors treat patients? 
If this advice is followed, it would lead to fewer patients getting skin exams. It would put the onus on patients to detect their own cancers. This is not really fair to a patient who, perhaps, has never seen a skin cancer. 

It also misses the opportunity to provide patients education, not only about the warning signs of skin cancer but means of avoiding cancer in the first place.

More from CafeMom: After Losing Her Daughter to Melanoma, This Mom Wants You to Stay Safe in the Sun

What do you personally think of the panel's recommendation?
Since it's my job to take care of patients who develop serious skin cancers that, unfortunately, still claim many thousands of lives each year, I question the message this sends to patients and physicians. 

The cost benefit here, in my opinion and that of expert groups like the American Academy of Dermatology, seems to be very much on the side of continuing screenings.

So what's your advice to patients?
Patients with a personal history of skin cancer or a family history of the disease should have at least an annual skin exam. If the risk is higher, even more frequent visits might make sense. 

For those who are fair-skinned, who have had sunburns, or who have numerous moles, at least a baseline check with a dermatologist is a good idea.

 

Image via Image Point Fr/Shutterstock

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