U.S. Task Force Struggles to Determine Whether Visual Skin Cancer Screening is Effective

Only high risk patients appear to benefit from visual skin cancer screening, researchers found

For individuals not experiencing any symptoms of skin cancer, a panel of experts indicates that visual exams do not seem to help diagnose melanoma early, or improve outcomes associated with the deadliest form of skin cancer.

The U.S. Preventative Services Task Force published new skin cancer screening recommendations in the Journal of the American Medical Association (JAMA) on April 18, which provides an update to recommendations previously issued in 2016.

However, the task force ended up not changing those recommendations after finding people who do not have symptoms do not seem to benefit from having their doctor conduct visual skin cancer screenings.

The task force reviewed 20 studies from June 2015 through January 2022, focusing on comparing the benefits and risks of screening for skin cancer among asymptomatic teens and adults. However, researchers concluded that the evidence is insufficient to determine a clear benefit of visual skin examination for skin cancer.

The researchers compared usual care and routine skin examinations. The data indicated that routine skin exams conducted by a patient’s doctor did not increase the detection of skin cancer or precursor lesions. It also did not improve early detection of melanoma , a type of skin cancer which can be fatal.

While some activities, like using indoor tanning beds, can increase a person’s risk of skin cancer, there is no need for visual screenings if the person does not have an increased risk, the task force concluded.

Several studies suggested there was no improvement in the melanoma death rates among those who underwent visual screenings. And about 15 studies provided inconsistent evidence on the effectiveness of skin examinations and whether they led to earlier diagnosis or reduced the risk of death. The data from the analysis was published along with the new recommendations.

“The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of visual skin examination by a clinician to screen for skin cancer in adolescents and adults,” the task force said in its recommendation statement.

The inconclusive recommendations on visual skin cancer screenings do not apply to patients who are showing symptoms of skin cancer, such as irregular moles, skin growth, or skin changes, or patients who have a family history of skin cancer.

Those types of patients can still benefit from visual screening, the task force noted.

Skin Cancer Health Risks

Skin cancer is the most commonly diagnosed cancer in the United States. The most common types of skin cancer are basal and squamous cell carcinomas but don’t commonly lead to death.

Melanoma, the deadliest type of skin cancer, makes up about 1% of skin cancer cases but causes the most skin cancer deaths.

Melanoma is 30 times more common in white people than in Black people, but people with darker skin tend to be diagnosed at later stages when the cancer is difficult to treat and can lead to death.

Patients who face a higher risk of developing skin cancer, such as people who use indoor tanning beds or booths, have suffered many sunburns, older people, and people with fair skin, light-colored eyes, or have a lot of moles, should regularly see their doctor for visual skin cancer screenings. At-risk Americans should be more concerned about their cancer risk overall.