Skin Cancer Screening

Skin cancers are exceedingly common malignancies in the United States and include keratinocyte cancers, which have low mortality rates but are costly to treat, and melanomas, which can be deadly if diagnosed at later stages. Skin cancer screening for the general population has not received recommendation by the United States Preventive Services Task Force, given the paucity of clinical trial data documenting utility, yet there are sound arguments for the utility of risk-based screening, based on increased skin cancer risk. Such risk factors include skin type, high mole number, genetic susceptibility, and family or personal history of skin cancers. Screening can involve an inspection of the entire skin surface performed by a dermatologist or other health care provider, or self-screening, whereby individuals conduct an examination of their skin surface at home, which can be facilitated through the use of a mirror, as well as a family member or friend to facilitate skin inspection. Rates of physician screening as well as skin self-examination are low in the United States. This chapter reviews the current evidence and recommendations for skin cancer screening in the United States. It also reviews the current rates of screening, both overall and in higher-risk subgroups. The chapter discusses the recent evidence for the use of interventions to enhance skin cancer screening. It also presents some innovative use of new technology to increase skin cancer screening as well as future directions for this research.