There is no evidence that the skin cancer screening saves lives. Yes, screening may pick up some early skin cancers, but they are very, very unlikely to cause death or even suffering. Screening is a marketing tool for physicians' services and skin cancer screening is no exception. It brings people into dermatology practices and increases the number of lucrative procedures dermatologists perform.
A spate of recent articles in the press has addressed breast, prostate and cervical screening. Gina Kolata summarized the data in a recent lucid article: Considering When It Might Be Best Not To Know About Cancer (NY Times, October 29, 2011). Read this article if you want a good summary of this topic.
One can extrapolate from Kolata's article to skin cancer screening. "The disease [cancer] was defined in 1845 by a German pathologist, Rudolf Virchow, who looked at tumors taken at autopsy and said cancer is an uncontrolled growth that spreads and kills. But, of course, he was looking only at cancers that killed. He never saw the others.
Now we are backing away from that, experts say. In recent years, researchers have found that many, if not most, cancers are indolent. They grow very slowly or stop growing altogether. Some even regress and do not need to be treated — they are harmless."
While this is true for skin cancers as well, dermatologists are still scaring patients. Isn't it time to stop doing this? It will be interesting to see if the American Academy of Dermatology and the Canadian Dermatology Association come clean.
The U.S. Preventive Services Task Force's reccomendation on skin cancer screening states: "the current evidence is insufficient to assess the balance of benefits and harms of screening for skin cancer by primary care clinicians or by patient skin self-examination. If this service is used, patients should be made aware of the uncertainty about the balance of benefits and harms."