What to know about screening for skin cancer

IOWA CITY — Having an early detection strategy for skin cancer that includes seeing a dermatologist is important to minimizing risk.

For most people, skin cancer is preventable, said Dr. Marta Van Beek, C. William Hanke Professor of Dermatology at the University of Iowa Hospitals and Clinics. While some of the risk is genetically predisposed, Van Beek said a lot of it is behavioral risk factors that individuals can modify by managing their time in the sun.

“If people are cognizant of protecting their skin and avoiding the sun during peak hours and wearing sunscreen, they can minimize their risk of skin cancer,” Van Beek said.

Skin cancer is the most common cancer in the United States. There are multiple types of skin cancer, and they range in how aggressive they are.

Van Beek said it’s important to get any lesion that’s bleeding or rapidly changing in size, shape or color checked by a board certified dermatologist to make sure it’s safe.

“Early intervention in identifying skin cancer when it is small provides the best cure rate possible,” Van Beek said.

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Key signs

One type of skin cancer is melanoma, and it is associated with pigmented lesions, also known as moles.

Van Beek explained how dermatologists identify a concerning lesion from one that is not concerning. This includes the ABCDEs — asymmetry, border, color, diameter and evolution.

Dermatologists want to see moles that are symmetrical in size with a regular border, one color, smaller than the size of a pencil eraser, and not evolving, Van Beek said.

Evolution of a mole is the most important feature, Van Beek said.

“If you've had a mole that's had one or more of those features for your entire life, we're less concerned,” Van Beek said. “But if you have a mole that's changing in any of those features, that is something that you want to have evaluated.”

There are other types of skin cancer that are not associated with moles, like basal cell carcinoma, Van Beek said. This is the most common type of skin cancer and is associated with chronic sun exposure. It often appears like a red papule that bleeds or erodes easily with minor trauma.

Van Beek said it’s important for everyone to take measures to protect their skin from the sun, like wearing sunscreen SPF 30 or greater, wearing protective clothing, and seeking shade.

When to schedule an annual skin cancer screening

How often and when to see a dermatologist depends on a person’s risk factors, Van Beek said.

For those with a family history of skin cancer and significant sun exposure, it’s recommended to make and appointment and establish care, Van Beek said.

Someone who has no family history and has been protecting themselves from the sun is lower risk. But if there is a concerning mole, then it’s recommended to make an appointment, Van Beek said.

The Skin Cancer Foundation, a nonprofit focused on skin cancer prevention, recommends individuals see a dermatologist once a year for a full-body skin exam, or more often for those who are high risk.

What to expect with a skin exam

Van Beek explained what a typical appointment might look like.

Typically, a dermatologist will ask the patient to get undressed and put on a medical gown or poncho. This allows the dermatologist to examine all areas of the skin.

“You may notice a lesion in an area that you can see that's easily accessible with your own eyes, but there may be other lesions that are concerning that you may not be able to see very easily on the back of your legs or on your back,” Van Beek said.

If there is a mole that might appear concerning, the dermatologist will likely recommend a biopsy, Van Beek said.

The biopsy can typically be done on the same day and includes numbing the area to take a sample of the skin. The only way to diagnose a skin cancer is by histology, or by looking at the tissue or skin underneath the microscope, Van Beek said.

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