“How often should I have a skin check?” I was asked by a 21 year old?
The younger you are the more difficult it is to answer this question. The problem is that the skin cancers are rare at younger age. From 0-14 yrs the chance of melanoma is 1-4 in a million, but mortality close to 100%. In adolescents and young adults melanoma is the most common reportable cancer diagnosed at about 100 per million, well above the global average (25 per million in the USA). To complicate matters this is also the time people develop most of their normal moles.
The current standard for skin checks is self-examination with opportunistic screening by a GP. While early diagnosis and treatment reduce melanoma mortality and non-melanoma skin cancer morbidity, Cancer Council Australia argues against mass population screening on economic grounds. The majority of melanomas are detected by patients themselves, or their partners. However, melanomas detected by physicians tend to be thinner and there is some consensus to suggest 6-12 monthly general practitioners may be beneficial for people at high risk.
People at high risk for skin cancer include those with:
- fair skin, a tendency to burn rather than tan, freckles, light eye colour, light or red hair colour;
- increased numbers of unusual moles (dysplastic naevi);
- depressed immune systems;
- a family history of melanoma in a first degree relative; and
- previous melanoma or NMSC.
Note the absence of age in this list, suggesting that any age is a good age to start self-examining: the earlier the better. Scanyourskin.org provides an online tool to assess your risk and knowyourownskin.com.au has an informative video on how to execute skin self-examination. You will know better than anyone else if something on your skin is new or changing – two important early warning signs, but it is your doctor’s job to diagnose skin cancer.
The best answer to the above question is probably that you should have a skin check when you are concerned you may have a skin cancer.
- The Australian Institue of Health and Welfare: Cancer in Australia An overview, 2008 and Cancer in adolescents and young adults in Australia
- Skin Checks. Australian Family Physician Vol 41,No7, July 2012
- Cancer Council Australia. Position Statement – Screening and early detection of skin cancer, accessed 30/4/2015
- www.scanyourskin.org Skin Cancer College Australasia, QMIR, MPA