Skin cancer screening (visual skin examination)
Checking the whole skin for suspicious moles finds melanomas earlier, but no trial has yet shown that screening everyone saves lives, so most countries target people at high risk.
Overview
The US Preventive Services Task Force concluded in 2023 (as in 2016) that evidence is insufficient to recommend for or against visual skin examination to screen asymptomatic adults (I statement). Germany introduced national skin cancer screening from age 35 in 2008 after the SCREEN pilot in Schleswig-Holstein, in which melanoma mortality initially fell but the decline was not sustained, and the programme is now the main natural experiment. Australia, with the highest incidence, relies on opportunistic examination and public awareness rather than a programme. Risk-based surveillance of people with many or atypical moles, prior melanoma or familial risk uses total-body photography and dermoscopy, increasingly with AI support, and sequential imaging in high-risk clinics reduces unnecessary excisions. Overdiagnosis of in situ and thin melanomas is the central controversy.
How it works
Whole-body visual examination by a trained clinician, with dermoscopy of suspicious lesions and excision for histology.
- Cheap and non-invasive
- Melanoma is highly curable when thin
- No randomised trial of mortality benefit
- Rising melanoma incidence without matching mortality change points to overdiagnosis
- Performance varies by skin tone and training
Latest papers
topQuery for this technology: (TITLE:"Skin cancer screening" OR ABSTRACT:"Skin cancer screening" OR TITLE:"visual skin examination" OR ABSTRACT:"visual skin examination") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Skin cancer screening (visual skin examination), not a curated reading list.
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