Skin Cancer Screening
The skin is the largest organ in the body.
Longterm sun exposure, due to unintended outdoor activity on a regular basis (eg commuting to work) or due to intentional activity such as sunbathing, can lead to increased risk of photo damage as well as increased risk of skin cancers.
Actinic Keratoses
Actinic keratoses are the result of abnormal skin cell development due to DNA damage by short wavelength UVB.
They are more likely if the immune function is poor, due to ageing, recent sun exposure, predisposing disease, or certain drugs.
Benign Skin Lesions
As we get older, we are also more predisposed to other skin lesions such as skin tags and growths that may be benign/ non cancer but which can be hard to tell.
Occasionally they may be in a place where they catch clothing, or they may be unsightly.
Removal of these is possible but needs a skin check to rule out the possibility of cancer first.
Benign Skin Lesions
As we get older, we are also more predisposed to other skin lesions such as skin tags and growths that may be benign/ non cancer but which can be hard to tell.
Occasionally they may be in a place where they catch clothing, or they may be unsightly.
Removal of these is possible but needs a skin check to rule out the possibility of cancer first.
Skin Cancers in Australia
Skin cancer is the uncontrolled growth of abnormal cells in the skin.
- Australia has one of the highest rates of skin cancer in the world.
- About 2 out of 3 Australians will be diagnosed with some form of skin cancer during their lifetime.
There are three main types of skin cancers; they are
- basal cell carcinoma (BCC),
- squamous cell carcinoma (SCC) and
- melanoma.
BCC and SCC are also called non-melanoma skin cancer (NMSC) or keratinocyte cancers.
Non Melanoma Skin Cancers (NMSC)
Non-melanoma skin cancer is the most common cancer diagnosed in Australia, the bulk of them by specialist GPs like Dr Joshi trained in skin cancer screening, diagnosis and surgery.
Over 1 million treatments are carried out each year in Australia for non-melanoma skin cancers.
- BCC can develop in young people, but it is more common in people over 40.
- SCC occurs mostly in people over 50.
Non Melanoma Skin Cancers (NMSC)
Non-melanoma skin cancer is the most common cancer diagnosed in Australia, the bulk of them by specialist GPs like Dr Joshi trained in skin cancer screening, diagnosis and surgery.
Over 1 million treatments are carried out each year in Australia for non-melanoma skin cancers.
- BCC can develop in young people, but it is more common in people over 40.
- SCC occurs mostly in people over 50.
Melanoma
Melanoma is a type of skin cancer that develops in the pigment producing skin cells called melanocytes.
Melanoma most often develops in areas that have been exposed to the sun but it can also start in areas that don’t receive much sun, such as
- the eye (uveal or ocular melanoma);
- the nasal passages, the mouth and the genitals (mucosal melanoma);
- the soles of the feet or palms of the hands, and under the nails (acral melanoma).
Australia and New Zealand have the highest rates of melanoma in the world.
Every year in Australia, about 17,800 people are diagnosed with melanoma that has spread into the dermis (known as invasive melanoma). About 27,500 people are diagnosed each year with melanoma that is confined to the epidermis (melanoma in situ).
Anyone of any age can develop skin cancer but as with all cancers it becomes more common as you get older.
If you are at risk, it is best to monitor your skin for any changes and to seek regular skin check appointments so any changes can be picked up early.
Who is at Risk for Skin Cancer?
Australia has one of the highest rates of skin cancer in the world and much of this has to do with our love for the outdoors, our sun-loving culture and our geographic location coupled with our population which is predominantly fair skinned.
Skin cancer is the most common cancer diagnosed in Australia.
About two in three Australians will be diagnosed with some form of skin cancer before the age of 70.
Almost 980,000 new cases of BCC and SCC are treated each year.
BCC can develop in young people, but it is more common in people over 40. SCC occurs mostly in people over 50.
Melanoma is the most common cancer diagnosed in young people between the ages of 15 and 39.
Australia and New Zealand have the highest rates of melanoma in the world.
Am I at risk of skin cancer?
Anyone can develop skin cancer, but it is more common in older people due to combined lifetime exposure.
The risk is also higher in people who have:
- Fair or freckled skin, especially if it burns easily and doesn’t tan
- Red or fair hair and light-coloured eyes (blue or green)
- Short, intense periods of exposure to UV radiation, e.g. on weekends or holidays or when playing sport, especially if it caused sunburn
- Actively tanned or used solariums
- Worked outdoors
- A weakened immune system, due to taking certain medicines after an organ transplant (immunosuppressants) or by ongoing blood conditions that affect one’s immune system.
- Many moles on their body or moles with an irregular shape and uneven colour (dysplastic naevi)
- Previous skin cancer or a family history of skin cancer
- Certain skin conditions such as sunspots due to prolonged sun exposure in the past.
People with olive or very dark skin have more protection against UV radiation because their skin produces more melanin than fair skin does BUT they can still develop skin cancer.
Low risk does not mean NO risk, especially if they do not have sun protection measures in place.
What Causes Skin Cancer?
The main cause of all types of skin cancer is overexposure to ultraviolet (UV) radiation.
The vast majority (95%) of skin cancers are caused by UV (sun) exposure.
When unprotected skin is exposed to UV radiation, the structure and behaviour of the cells can change.
UV radiation is produced by the sun, but it can also come from artificial sources, such as the lights used in solariums (sun beds), which are now banned in Australia because research shows that people who use solariums have a high risk of developing skin cancer.
Most parts of Australia have high levels of UV radiation (Index 3 and above) all year round even if it cannot be seen or felt.
Unlike heat, UV it is also not related to temperature. The UV Index (UVI) can be well above 3 on a winter day, and also a rainy day.
It can cause:
- sunburn
- premature skin ageing
- damage to skin cells, which can lead to skin cancer
- pigmentary and textural changes
Why is Australia’s sun so strong?
During summer, the Earth’s orbit brings Australia closer to the sun (compared to Europe during its summer) giving rise to 7% more solar UV exposure.
In combination with clearer atmospheric conditions (due to a smaller population) it means that Australians are exposed upto 15% more UV annually than Europeans.
Additionally, since the 1970s, a gradual thinning of the ozone layer has become apparent, especially at the North and South Poles, resulting in loss of a protective layer for UV rays, which are better able to penetrate and reach Earth.
This depletion is believed to be directly related to the rise in skin cancer cases, resulting in more UV/ sun exposure and increase risk of sunburn, both of which are significant risk factors for skin cancers.
Skin Cancer Clinic Frequently Asked Questions
How long does a skin check take?
You may want to allow 15-30 minutes for your skin check. You will be emailed a form to fill out on booking to save time at your appointment.
At your initial appointment, you will have a consulation with your doctor who will take a relevant medical history prior to the skin check, which will take anywhere from 5-15 minutes depending on how many moles/ freckles/ sun damage you have on your body. if a sample is needed to confirm or rule out cancer (a biopsy) this will be an added cost and discussed with you on the day.
What does a skin check involve?
You will be asked if you are comfortable undressing down to your underwear – this is ideal and best so your doctor can see your skin without any clothes hiding any potential skin from view. The doctor will then examine your skin from head to toe, including any exposed skin on your scalp as necessary up close and with the use of a non invasive instrument with a very bright light called a dermatoscope, which is handheld and which allows them to look at moles and other lesions up close.
If we see anything of concern, we will discuss this with you at the time, and depending on the size of the lesion, and if there is time, we may offer you a biopsy then, which is a sample of the skin of concern to be sent for diagnostic pathology, or we may rebook you to come back for a biopsy or an excision biopsy (removal of the lesion entirely). This is an additional cost that will be discussed with you at the time.
How much does a skin check cost?
We are a privately billing clinic and the cost for a standard skin check is listed in the booking link, (higher rates apply on a Saturday) depending on the amount of time taken, the complexity of your needs and the number of moles.
With a valid Medicare card, we will claim the rebate of the eligible parts of the consultation for you after the appointment.
How often should I be having skin checks?
The general recommendation is that most adults, especially if fair skinned or fair haired, should consider beginning regular skin checks by the time they are around 25. It is recommended that all adults should check their own skin every 6 months and have a friend or partner keep an eye on areas they can’t visualise themselves such as the back, and see a doctor for a full, standard skin check at least annually, if there is no personal or family history of cancer.
Even in people with darker skin tones, low risk does not mean no risk, especially if they have had unintended sun exposure in their childhood and youth, a history of sunburns, or of tanning.
Do you provide workplace skin checks?
Yes. We are able to provide workplace skin screening for 20 or more employees as part of workplace screening. Please email the clinic directly for more information.