Screening is looking for cancer before a person has any symptoms. This can help find cancer at an early stage. When abnormal tissue or cancer is found early, it may be easier to treat. By the time symptoms appear, cancer may have begun to spread.
Scientists are trying to better understand which people are more likely to get certain types of cancer. They also study the things we do and the things around us to see if they cause cancer. This information helps doctors recommend who should be screened for cancer, which screening tests should be used, and how often the tests should be done.
It is important to remember that your doctor does not necessarily think you have cancer if he or she suggests a screening test. Screening tests are given when you have no cancer symptoms.
If a screening test result is abnormal, you may need to have more tests done to find out if you have cancer. These are called diagnostic tests.
The skin is the body's largest organ. It protects against heat, sunlight, injury, and infection. Skin also helps control body temperature and stores water, fat, and vitamin D. The skin has several layers, but the two main layers are the epidermis (top or outer layer) and the dermis (lower or inner layer). Skin cancer begins in the epidermis, which is made up of three kinds of cells:
There are two main types of skin cancer:
Basal cell carcinoma and squamous cell carcinoma of the skin, also called nonmelanoma skin cancer or keratinocyte carcinoma, are the most common forms of skin cancer. Most basal cell and squamous cell skin cancers can be cured.
Melanoma is more likely to spread to nearby tissues and other parts of the body and can be harder to cure. Melanoma is easier to cure if the tumor is found before it spreads to the dermis (inner layer of skin). Melanoma is less likely to cause death when it is found and treated early.
In the United States, about 3 million cases of nonmelanoma skin cancer or keratinocyte carcinoma are diagnosed each year, and rates have likely been increasing for decades but have recently stabilized. Greater public awareness has led to higher rates of screening exams, self-exams, and detection of these skin cancers.
Since the early 2000s, the rate of melanoma cases in adults younger than 50 years has held steady in women, but decreased by about 1% per year in men. From 2015 to 2019, the rate of melanoma cases in adults aged 50 years and older appeared to hold steady in men, but increased by about 1% per year in women. From 2011 to 2020, the number of deaths from melanoma decreased by about 5% per year in adults younger than 50 years and by 3% per year in adults aged 50 years and older.
The rate of melanoma cases in children and adolescents increased until 2002. However, between 2002 and 2019, the yearly rates of melanoma in these age groups decreased slightly.
For more information about skin cancer, see the following:
Anything that increases your chance of getting a disease is called a risk factor. Anything that decreases your chance of getting a disease is called a protective factor.
For information about risk and protective factors for skin cancer, see Skin Cancer Prevention.
Scientists study screening tests to find those with the fewest harms and most benefits. Cancer screening trials also are meant to show whether early detection (finding cancer before it causes symptoms) helps a person live longer or decreases a person's chance of dying from the disease. For some types of cancer, the chance of recovery is better if the disease is found and treated at an early stage. There is not enough evidence to know if screening the population for skin cancer lowers the rates of death from skin cancer.
A visual self-exam by the patient and a clinical examination by the health care provider may be used to screen for skin cancer.
During a skin exam a doctor or nurse checks the skin for moles, birthmarks, or other pigmented areas that look abnormal in color, size, shape, or texture. Skin exams to screen for skin cancer have not been shown to decrease the number of deaths from the disease.
Regular skin checks by a doctor are important for people who have already had skin cancer. If you are checking your skin and find a worrisome change, you should report it to your doctor.
If an area on the skin looks abnormal, a biopsy is usually done. The doctor will remove as much of the suspicious tissue as possible with a local excision. A pathologist then looks at the tissue under a microscope to check for cancer cells. Because it is sometimes difficult to tell if a skin growth is benign (not cancer) or malignant (cancer), you may want to have the biopsy sample checked by a second pathologist.
Most melanomas in the skin can be seen by the naked eye. Usually, melanoma grows for a long time under the top layer of skin (the epidermis) but does not grow into the deeper layer of skin (the dermis). This allows time for skin cancer to be found early. Melanoma is easier to cure if it is found before it spreads.
Mobile phone applications ("apps") that evaluate skin lesions to detect skin cancer and malignant melanoma have been developed. However, these apps require further study in large-scale testing programs to find out if they are accurate and useful for skin cancer screening.
Information about clinical trials supported by NCI can be found on NCI’s clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.
Decisions about screening tests can be difficult. Not all screening tests are helpful and most have risks. Before having any screening test, you may want to discuss the test with your doctor. It is important to know the risks of the test and whether it has been proven to reduce the risk of dying from cancer.
Screening may not improve your health or help you live longer if you have advanced skin cancer.
Some cancers never cause symptoms or become life-threatening, but if found by a screening test, the cancer may be treated. Treatments for cancer may have serious side effects.
Screening test results may appear to be normal even though cancer is present. A person who receives a false-negative test result (one that shows there is no cancer when there really is) may delay getting medical care even if there are symptoms.
Screening test results may appear to be abnormal even though no cancer is present. A false-positive test result (one that shows there is cancer when there really isn't) can cause anxiety and is usually followed by more tests (such as a biopsy), which also have risks.
When a skin biopsy is done, the doctor will try to leave the smallest scar possible, but there is a risk of scarring and infection.
Talk to your doctor about your risk for skin cancer and your need for screening tests.
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PDQ® Screening and Prevention Editorial Board. PDQ Skin Cancer Screening. Bethesda, MD: National Cancer Institute. Updated . Available at: https://www.cancer.gov/types/skin/patient/skin-screening-pdq. Accessed . [PMID: 26389182]
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