From the Guidelines
The American Cancer Society recommends a cancer-related checkup by a physician, including a skin examination, during a periodic health examination for people age 20 years or older, and monthly skin self-examination by all individuals. When considering the recommended skin screening schedule, several factors come into play, including individual risk factors and guidelines from various health organizations.
Key Recommendations
- The American College of Preventive Medicine recommends that total cutaneous examinations be performed, targeting populations at high risk for malignant melanoma 1.
- The American Academy of Dermatology promotes free skin examinations by volunteer dermatologists for the general population through the Academy's Melanoma/Skin Cancer Screening Program, and encourages regular self-examinations by individuals 1.
- The American College of Obstetricians and Gynecologists recommends skin examinations for females age 13 years or older with increased recreational or occupational exposure to sunlight, family or personal history of skin cancer, or clinical evidence of precursor lesions 1.
Screening Schedule
For the general population, an annual full-body skin examination by a dermatologist is recommended, starting at age 20-30. Those with higher risk factors such as a personal or family history of skin cancer, numerous moles, fair skin, history of sunburns, or immunosuppression should be screened more frequently, typically every 3-6 months. Between professional examinations, monthly self-examinations are advised for everyone. During self-exams, check your entire body including scalp, between toes, and genital areas, looking for any changes in existing moles or new growths using the ABCDE rule (Asymmetry, Border irregularity, Color variation, Diameter larger than 6mm, and Evolution or change). Regular screenings are important because early detection of skin cancers, particularly melanoma, significantly improves treatment outcomes, as noted by the U.S. Preventive Services Task Force 1. Skin cancers caught early are typically easier to treat and have better prognosis than those discovered at advanced stages.
Importance of Early Detection
Early detection of skin cancers is crucial for improving treatment outcomes and reducing mortality from melanomatous skin cancer, as visual examination of the skin in asymptomatic individuals may lead to a reduction in mortality from melanomatous skin cancer 1.
From the Research
Skin Screening Schedule
There is no universally recommended skin screening schedule, but various studies provide insights into the frequency of skin examinations.
- A study published in 2011 2 found that 71.7% of dermatologists reported routinely performing self-skin examinations, with 25.4% doing so monthly, 24.5% every six months, 17.2% once per year, and 4.6% every five years.
- Another study from 2004 3 reported that 32% of patients underwent regular full-body skin examinations by their primary care practitioner, while 55% of those with a history of skin cancer underwent such examinations.
- A 2017 study 4 emphasized the importance of total body skin examinations in adults and children, highlighting the need for dermatologists to be comfortable and competent in performing these examinations in patients of all ages.
- However, none of these studies provide a clear recommendation for a skin screening schedule, and the frequency of examinations may vary depending on individual risk factors and medical history.
Risk Factors and Screening
Certain risk factors, such as a history of skin cancer, may increase the likelihood of undergoing skin examinations.
- The 2004 study 3 found that patients with a personal history of skin cancer were more likely to be screened.
- The 2011 study 2 found that performing self-skin examinations was not related to age, gender, or history of skin malignancy among dermatologists.
Topical Treatments and Skin Examinations
While topical treatments for skin cancer are being developed and researched, the relationship between these treatments and skin screening schedules is not directly addressed in the provided studies.
- A 2020 review 5 discussed the potential benefits of topical treatments for skin cancer, including higher drug levels at the tumor site and less overall toxicity.
- A 2023 review 6 evaluated evidence-based recommendations for topical treatments of various cutaneous malignancies, but did not discuss skin screening schedules.