Should you get screened for skin cancer?
By Nicholas St. Fleur
New York Times, July 26, 2016
In July 2016, the U. S. Prevention Services Force stated that there is no good evidence for the efficacy of skin cancer screening to prevent death or significant disability. This means that the benefits do not outweigh the potential harm of skin cancer screening.
Nonmelanoma skin cancer comprises 98% of skin cancer's and account for only about .1% of all cancer deaths. Melanoma accounts for about 10,000 cancer deaths a year.
If you have a personal or family history of melanoma, and if you have more than 100 moles you should probably consider being screened. But if not, you could safely pass. A large study in Germany found that skin cancer screening can potentially save one life per hundred thousand individuals screened. It is likely that much more harm could be done from over diagnosis and over treatment in a large screen and population.
Screening picks up small very slow growing or not even growing melanomas that are not destined to harm a patient. However, once they are discovered usually aggressive therapy is recommended and the patient is then labeled as a cancer survivor.
Most dermatologists recommend skin screening. In spite of the lack of evidence for its efficacy, it's good business practice for skin doctors. A skillful dermatologist can find something to treat with cryotherapy or a biopsy on most older caucasians, and this provides a good living for these doctors. It's a low risk screening and a high-value return for dermatologists.
The smart patient should avoid skin cancer screenings if they are not at risk. They should specifically avoid the free skin cancer screenings offered by many hospitals and aggressively promoted by the American Academy of Dermatology. They can just say no. If they have risk factors for skin cancer or are worried about specific lesions they can request a complete skin examination. This may be a good way of alleviating anxiety related to specific skin lesions.
The article in July 26, 2016 New York Times is a good overview. It can be accessed at: http://nyti.ms/2albmU/