Skin Cancer Screening

What is a skin cancer screening?

Cancer screening is checking for signs of cancer before you have any symptoms. A skin cancer screening includes looking at all of your skin to check for signs of skin cancer. Signs of skin cancer can be seen with just your eyes.

Skin cancer is very common, and screening can help find it when it's easier to treat. Your health care provider can do a skin cancer screening, and you can also check your skin yourself. To do a skin cancer screening, you or your provider check your skin for moles, birthmarks, or other areas that have an unusual color, size, shape, or texture. If an area of skin doesn't look normal, you may need tests to find out if it's cancer.

The most common types of skin cancer are basal cell and squamous cell cancers. These cancers rarely spread to other parts of the body and treatment usually cures them.

Melanoma is a less common type of skin cancer, but it's more serious. That's because it's more likely to spread to nearby tissues and other parts of your body. It can be harder to cure and may be fatal. Melanoma is easier to cure if it's found when it's growing only in the top layer of skin. And it's less likely to be fatal when it's treated early.

Other names: skin exam

What is it used for?

Skin cancer screening is used to look for signs of skin cancer. It's not used to diagnose cancer. If a screening test finds signs of skin cancer, you may need to have a test called a skin biopsy to find out whether you have cancer.

Why do I need a skin cancer screening?

Some medical experts recommend checking your own skin regularly starting at age 18. That's because skin cancer is very common, and people of all skin colors can get it.

A skin cancer screening with your provider or with a dermatologist (a doctor who specializes in skin disorders) may be important if you:

• Find a suspicious area of skin during a self-exam.
• Have had skin cancer in the past. In this case, it's usually recommended to have a regular yearly skin cancer screening with your provider or a dermatologist
• Have a higher-than-normal risk for getting skin cancer:
  • Your risk for all types of skin cancer is higher if you have:
    • Had frequent exposure to natural sunlight or artificial sunlight, such as tanning beds
    • Pale skin that burns and freckles easily
    • Skin that tans a little or not at all
    • Blond or red hair
    • Light colored eyes, including blue or green
  • Your risk for basal cell or squamous cell cancer is higher if you have had:
    • Actinic keratosis, patches of thick, scaly skin
    • Radiation therapy for cancer
    • A weakened immune system
    • Exposure to arsenic
  • Your risk for melanoma is higher if you:
    • Had many blistering sunburns, especially as a child or teenager
    • Have a personal and/or family health history of melanoma
    • Have a family health history of unusual moles, such as Gorlin syndrome or xeroderma pigmentosum
    • Have several large or many small moles

Ask your provider how often to do a self-exam and whether you need to have regular skin cancer screenings from a provider, too.

What happens during a skin cancer screening?

For a self-exam to screen for skin cancer, you'll check your skin to look for:

• Changes in the size, shape, or color of an existing mole or spot
• Moles or other skin spots that ooze, bleed, or become scaly or crusty
• Moles that are painful to the touch
• Sores that haven't healed within two weeks
• Shiny pink, red, pearly white, or translucent bumps
• The "ABCDEs" of melanoma, which stands for:
  • Asymmetry: Does the mole or spot have an irregular shape with two parts that look very different?
  • Border: Is the border of the mole ragged or irregular?
  • Color: Is the color uneven?
  • Diameter: Is the mole or spot bigger than the size of a pea or a pencil eraser?
  • Evolving: Has the mole or spot changed during the past few weeks or months?

To do a head-to-toe self-exam:

• Choose a well-lit room with a full-length mirror. You'll also need a hand-held mirror.
• Check you scalp. Part your hair and look with a hand mirror. It may also help to use a blow dryer to move your hair as you look. Check the back of your neck, too.
• Look at your face, ears, and front of your neck.
• Look at the front of your chest and belly. Lift breasts to check the skin underneath.
• Raise your arms and check the skin on your left and right sides, including your underarms.
• Look at the front and back of your arms.
• Check your hands, including between your fingers and fingernails (without nail polish).
• Check your back and buttocks with a hand mirror.
• Sit down to check the front and sides of your legs and use the hand mirror to check the backs of your legs and your genitals.
• Check your feet, including the bottoms, the spaces between your toes, and the nail of each toe (without nail polish).

For a skin cancer screening by a provider, you'll remove your clothing and put on a gown. Your provider will do a full exam that includes your scalp, behind your ears, fingers, buttocks, and feet. Your provider may use a special magnifying glass with a light to look more closely at certain moles or spots. The exam should take 10-15 minutes.

Will I need to do anything to prepare for the test?

You should not wear makeup or nail polish. You will need to have your hair loose so your scalp can be checked.

Are there any risks to the test?

Skin cancer screening isn't always helpful and may have risks. You may want to discuss these possible risks with your provider:

• Your screening test could find a cancer that would never cause health problems. Not all skin cancers cause symptoms or threaten your life. But if they're found during screening, you may have cancer treatment which could cause side effects.
• Finding advanced skin cancer may not help you live longer. Advanced skin cancer is cancer that's unlikely to be cured or controlled with treatment. It may have spread to other parts of your body. Finding advanced skin cancer during a screening may not change how the cancer affects you.
• Your screening test results could show that you have skin cancer, but you really don't. This is called a "false positive." If you have a false positive, you may have other tests that have risks, such as a skin biopsy. A skin biopsy may cause scarring. Thinking you have cancer may also make you feel anxious.
• Your skin cancer screening result could be normal, but you have skin cancer. This is called a "false negative." A false negative may delay your medical care for the cancer.

What do the results mean?

If you find a mole or other spot on your skin that concerns you, contact your provider. If you or your provider finds a sign of skin cancer, you'll probably have a skin biopsy to find out whether you have cancer.

A skin biopsy is a procedure that removes a small sample of skin for testing. The skin sample is checked under a microscope to look for cancer cells. Not all suspicious spots turn out to be skin cancer. If the biopsy shows that you do have skin cancer, your provider will talk with you about your treatment options.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a skin cancer screening?

There are mobile phone apps that use the camera of your phone to check skin moles and spots to help find skin cancer. These apps need to be studied to see if they are accurate and useful for skin cancer screening.