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Are Skin Exams Worthwhile?

By March 8, 2009

Skin cancer is often first recognized when patients themselves notice skin changes, which they bring to their doctor's attention. Skin cancer screening is a bit different: it involves primary care doctors doing a whole-body skin examination on all patients regardless of whether the patient has noticed a skin change. The potential benefits of screening are that doctors might find early skin cancer that patients had not noticed. The potential harm of screening is that it could mistakenly identify unimportant skin changes that could lead to unnecessary procedures and treatments.

So are these whole-body exams really worthwhile for patients who have no particular risk of developing basal cell carcinoma, squamous cell carcinoma or melanoma, have no history of cancer, and who have no symptoms? That was the question posed by the U.S. Preventive Services Task Force, a group of health experts that makes recommendations about preventive health care. The short, if unsatisfying, answer: there is not enough evidence to say one way or the other.

There is some evidence that primary care doctors can miss real cancerous lesions and can identify benign lesions as cancerous. But there aren't many of these studies, and the existing ones use photos rather than real patients. What's more, there simply haven't been enough clinical trials about how whole-body screening impacts survival of those who are diagnosed with skin cancer.

Regardless of this latest study, if you have one or more of the risk factors for nonmelanoma or melanoma skin cancer, the advice of the American Cancer Society, the American Academy of Dermatology, and most other experts remains the same: check your skin yourself at least once per year, and see a dermatologist regularly. If you don't have any specific risk factors, do it anyway! It's easy, quick and free.


Wolff T, Tai E, Miller T. "Screening for Skin Cancer: An Update of the Evidence for the U.S. Preventive Services Task Force." Ann Intern Med 2009 150:188-193.

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