Download Screening for Skin Cancer: Consumer Guide (Draft Recommendation)

Understanding Task Force
Draft Recommendations
This fact sheet explains the Task Force’s draft recommendation statement on screening for skin cancer. It also tells you how you
can send comments about the draft recommendation to the Task Force. Comments may be submitted from December 1 to
December 28, 2015. The Task Force welcomes your comments.
Screening for Skin Cancer
The U.S. Preventive Services Task Force (Task Force) has
issued a draft recommendation statement on Screening
for Skin Cancer.
This draft recommendation statement applies to adults
who do not have any signs or symptoms of skin cancer
and who do not have a history of skin cancer. It does not
apply to adults who have developed abnormal skin
changes or to those who are already under a doctor’s care
because they are at high risk of developing skin cancer.
Individuals who have concerns about their skin should
talk with their doctor.
What is skin cancer?
The draft recommendation statement summarizes what
the Task Force learned about the potential benefits and
harms of screening for skin cancer, specifically for
melanoma: There is not enough evidence on the benefits
and harms of routine visual skin examinations by a
doctor to recommend for or against this skin cancer
screening test in adults who have no signs or symptoms
of skin cancer.
Skin cancer is cancer that occurs in different kinds of cells in the epidermis, the
outer layer of the skin. The three main types of skin cancer are melanoma, basal cell
carcinoma, and squamous cell carcinoma.
Facts About Skin Cancer
Skin cancer is the most common type of cancer in the United States. Two types—basal cell and squamous
cell—make up 97% of all skin cancers. These types of skin cancer, which rarely cause death, are also called
nonmelanoma skin cancer.
The third main kind of skin cancer is melanoma. Only about 3% of skin cancers are melanoma, but it is much more likely to result
in death than nonmelanoma skin cancer. In 2015, 74,000 adults in the United States will develop melanoma and nearly 10,000 will
die from the disease.
Like many cancers, the risk of melanoma increases with age. Skin cancer of any type occurs more commonly in men than in
women, and among individuals who:
• Have blonde or red hair, light eye color, and fair skin that freckles and sunburns easily
• Use indoor tanning beds
• Have a past history of sunburns or skin cancer
• Have a family history of melanoma
Additional factors that place an individual at high risk of developing melanoma include having abnormal moles and having more
than 100 moles.
Comment Period from December 1 to December 28, 2015.
Task Force DRAFT Recommendation | 1
Screening for Skin Cancer
The usual way doctors screen for any type of skin cancer is a visual skin examination to look for moles and other spots with color
different from the rest of the skin. In this exam, doctors follow the ABCDE rule to look for the following:
• A = asymmetry (one half of the mole does not match the other half)
• B = border irregularity (edges of the mole are ragged, notched, or blurred)
• C = color (color of the mole is not uniform, with different shades of tan, brown, or black)
• D = diameter of more than 1/4 inch (about the size of a pencil eraser)
• E = evolving (the mole is changing over time)
Doctors may also use a dermascope, which is like a magnifying lens with a bright light attached to it, to further inspect the mole or
spot. Sometimes, they use whole body photography to assess changes in the growth.
Potential Benefits and Harms of Skin Cancer Screening
In its examination of the evidence, the Task Force focused on whether a visual skin cancer examination by a doctor can ultimately
reduce illness and deaths from melanoma, the most serious form of skin cancer. It also looked at possible harms from the screening
itself as well as any procedures that occur as a result of the screening.
The Task Force found there is not enough evidence to know for certain whether a visual skin cancer screening examination by a
doctor reduces deaths from melanoma.
It also did not find much information about harms of screening. Potential harms include unnecessary procedures (such as a skin
biopsy or excision) for lesions that do not turn out to be cancer, or for skin cancers that would never have gone on to harm the person
or result in death. A biopsy involves taking a sample of tissue to examine it more closely for possible cancer. Biopsies and excisions
may have harms, such as poor cosmetic outcomes, or, rarely, scarring or other problems that interfere with feeling or ability to move a
part of the body.
Because of this lack of information, the Task Force is calling for more research to better understand the balance of potential benefits
and harms of visual skin cancer examinations for melanoma screening.
The Draft Recommendation on Screening for Skin Cancer: What Does It Mean?
Here is the Task Force’s draft recommendation on screening for skin cancer. The grade is based on the quality and strength of the
evidence about the potential benefits and harms of the screening. Task Force recommendation grades are explained in the box at the
end of this fact sheet.
When there is not enough evidence about a screening test to judge benefits and harms, the Task Force does not make a
recommendation for or against the test—it issues an I Statement. The Notes explain key ideas.
Before you send comments to the Task Force, you may want to read the full draft recommendation statement. The recommendation
statement explains the evidence the Task Force reviewed and how it decided on the grade. An evidence report provides more detail
about the studies the Task Force reviewed.
Comment Period from December 1 to December 28, 2015.
Task Force DRAFT Recommendation | 2
Screening for Skin Cancer
Notes
1
The Task Force concludes that the current evidence is
insufficient to assess the balance of benefits and harms of
visual skin cancer screening in adults. I Statement
1 current evidence is
insufficient
The Task Force did not find
enough information to know
whether this screening test can
prevent deaths from melanoma.
visual skin cancer
screening
An examination in which a doctor
looks at a person’s skin to assess
whether there are any abnormal
growths or other changes that
might suggest skin cancer.
adults
For purposes of this
recommendation statement,
adults means people ages 18 and
older who do not have any signs
or symptoms of skin cancer and
who do not have a history of skin
cancer. It does not apply to adults
who have developed abnormal
skin changes or to those who are
already under a doctor’s care
because they are at high risk of
developing skin cancer.
Comment Period from December 1 to December 28, 2015.
Task Force DRAFT Recommendation | 3
Screening for Skin Cancer
What is the U.S. Preventive Services Task Force?
The Task Force is an independent, volunteer group of national experts in prevention and
evidence-based medicine. The Task Force works to improve the health of all Americans
by making evidence-based recommendations about clinical preventive services, such as
screenings, counseling services, and preventive medicines. The recommendations apply
to people with no signs or symptoms of the disease being discussed.
To develop a recommendation statement, Task Force members consider the best
available science and research on a topic. For each topic, the Task Force posts draft
documents for public comment, including a draft recommendation statement. All
comments are reviewed and considered in developing the final recommendation
statement. To learn more, visit the Task Force Web site.
Task Force Recommendation Grades
Grade
Take Steps to Prevent
Skin Cancer
(healthfinder.gov)
Skin Cancer
(National Cancer Institute)
Melanoma
(Medline Plus)
Definition
A
Recommended.
B
Recommended.
C
Recommendation depends on the patient’s situation.
D
Not recommended.
I statement
Click Here to Learn More
About Skin Cancer
There is not enough evidence to make a recommendation.
Click Here to Comment on the Draft Recommendation
December 1 December 28, 2015
The Task Force welcomes comments
on this draft recommendation.
Comments must be received between
December 1 and December 28, 2015.
Comment Period from December 1 to December 28, 2015.
All comments will be considered for
use in writing final recommendations.
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