How Often Should I get a Skin Check?

magnify glass looking at mole
0

B

As GP’s we often turn to documents such as the RACGP Guidelines for Preventative Activities in General Practice (otherwise known as the ‘Red Book’) and disease-specific clinical guidelines such as those from the Cancer Council. Here is where the vagueness comes in. The Red Book guidelines say: “Screening of asymptomatic (low-risk) people for melanoma or non-melanocytic skin cancer (NMSC) is not recommended as there is insufficient evidence available to show that this reduces death.”

 

But herein lies the problem: most adults living in Australia and particularly Queensland are high risk, unless they are naturally dark-skinned. Higher risk includes having a family history of skin cancer, fair complexion, tendency to burn, presence of freckles, light or red hair colour, presence of ‘sun spots’, high levels of UV exposure, and sunburn in childhood. That’s almost every adult in Queensland with light-coloured skin!

 

A German study screened 360 000 people performed by a trained GP. After 6 years the rate of melanoma mortality in the screened population had declined by almost 50% compared to comparable nearby unscreened populations. This is quite compelling evidence that inviting people to have a full skin check by a trained GP detects cancers and saves lives.

 

There are various online tools you can use to help determine your own risk of skin cancer. There is a tool called the QSkin Risk Calculator that determines your personal risk score for developing a keratinocyte cancer (a BCC or SCC) in the next 3 years. I have fair skin and grew up in Australia, so my personal risk score over the next 3 years was ‘above average’. To determine your risk of melanoma, a separate online tool exists available here https://www.melanomarisk.org.au.

 

For most caucasian adults living in Queensland, skin cancer experts recommend an annual skin check as a default. We then might modify the frequency of that recommendation based on our appraisal of your personal risk. For example, if someone has already had multiple skin cancers and is therefore very high risk, we would usually recommend a 6 monthly full skin check. At the other end of the spectrum, if someone is a younger adult with favourable skin and good sun protection habits, we might stretch out this recommendation to a 2 yearly skin check, sometimes longer.

 

The common theme across all recommendations is to encourage good sun safety habits (remember the old Slip, Slop, Slap; and now Seek and Slide campaign?) and familiarity with your own skin. A guide to checking your own skin can be found here: https://www.sunsmart.com.au/skin-cancer/checking-for-skin-cancer The recommendation is to do this on yourself 4 times per year.

 

Get yourself and your partner to check each other’s backs. In our experience as skin cancer doctors (and my own personal experience), most people are pretty slack with this. Therefore, it’s recommended to discuss your own skin surveillance strategy with your GP or a skin cancer doctor if your own GP isn’t as well-versed in skin cancer (after all, as GP’s we all have our own areas of interest and extra knowledge and other areas we aren’t as knowledgeable in).

If it’s been a while since your last skin check, and there’s something you’re concerned about on your skin, our experienced female and male skin cancer doctors would be happy to help. Very often we can quickly reassure you that the spot is benign (the most common scenario).

If it’s been a while since your last skin check, and there’s something you’re concerned about on your skin, our experienced female and male skin cancer doctors would be happy to help. Very often we can quickly reassure you that the spot is benign (the most common scenario). On the other hand, if we can’t reassure you the spot is definitely benign, we’ll usually offer a biopsy, which is a small procedure to send a small sample of the area of concern to the pathologist who will look at it under the microscope and give us an answer. Either way, you’ll have the reassurance of a quick answer and a plan in place. I invite you to call the practice or book online for your skin check.