Two in three Australians will be diagnosed with skin cancer during their lifetime, according to Cancer Council, and about 95 per cent of skin cancers can be treated successfully when they are found early. For a risk that common, the amount of folklore around skin checks is remarkable. Some of it stops people booking a check at all, and some of it gives people false comfort. Here are seven beliefs worth correcting.
1. “If it really mattered, there would be a screening program”
There isn’t one, and that surprises people. No kit or invitation arrives in the post the way it does for bowel or breast screening, because the evidence does not show that routinely examining everyone, concerns or not, would do more good than harm. Australia runs a risk based approach instead, and it quietly shifts the responsibility onto you: get to know your skin, check it regularly, and see a doctor promptly about anything new or changing.
2. “A professional check is expensive and a hassle to organise”
You do not need a referral to have your skin looked at, and it does not have to cost anything. GP led skin cancer clinics have become a fixture of Australian primary care, staffed by GPs with additional training in skin cancer medicine rather than dermatologists, and some bulk bill. Kildare Road Medical Centre in Blacktown, in Sydney’s west, is one example: its skin cancer clinic bulk bills initial skin checks for anyone with a valid Medicare card, appointments run about 15 to 20 minutes, and the clinic’s doctors are members of the Skin Cancer College Australasia. Wherever you live, those are the things worth looking for when choosing where to go.
3. “Everyone should get checked once a year”
There is no set guideline on how often Australian adults should have their skin checked. Cancer Council’s guidance on checking for skin cancer is to monitor your own skin regularly, including the parts that never see the sun, and to have a doctor look at anything new or changed. Risk changes the equation. Fair or freckled skin that burns rather than tans, red or fair hair with light coloured eyes, lots of moles or irregular moles, a history of bad sunburns, tanning or solarium use, outdoor work, a weakened immune system, a previous skin cancer or a family history of the disease all push you into the higher risk group. If several of those sound like you, agree on a schedule with your doctor. For many higher risk patients that lands at a full skin examination with dermoscopy, sometimes supported by photography, every six to twelve months.
4. “A skin check is a quick glance at your moles”
A proper check is a head to toe examination. You undress to your underwear and the doctor works over your whole skin, usually with a dermatoscope, a handheld magnifier with its own light source that shows structures beneath the skin’s surface. Spots of interest may be photographed or measured so changes can be tracked at future visits, and if something needs a closer look, a small biopsy can often be done on the day. Anything bigger is normally booked separately with the cost explained first. Two tips make the appointment work better: skip the makeup, sunscreen and moisturiser beforehand, and mention any spot that has been on your mind, even if it seems minor. Plenty of spots that worry people turn out to be harmless, and finding that out is part of what the appointment is for.
5. “Doctors are the ones who find melanomas”
Most melanomas are first found by the person who has one, or by their partner, not by a doctor. That single fact is the best argument for checking your own skin between professional visits. Do it in a room with good light, undressed, with a full length mirror and a hand mirror for the awkward angles, or ask someone you trust to help with your back and scalp. Once you know what your skin normally looks like, changes stand out.
6. “A melanoma is a dark, ugly mole”
Sometimes. The ABCDE guide (asymmetry, border, colour, diameter, evolving) is a useful memory aid, but not every melanoma follows it, and some are pink or skin coloured rather than dark. What you are really looking for is anything new, anything changing in size, shape or colour, and any sore that does not heal or keeps bleeding. When in doubt, the rule is boring and reliable: a new or changed spot earns a trip to the doctor.
7. “Skin cancer only happens to fair skinned people”
Darker skin produces more melanin, which generally gives more protection against UV, but the risk is lower rather than zero. Skin cancers in darker skin sometimes appear in less sun exposed places, which is one more reason whole body checks matter. The same rule applies to everyone: anything new or changing deserves a look.
Frequently asked questions
Are skin checks bulk billed?
It varies by practice. Some skin cancer clinics bulk bill the screening check itself for Medicare card holders, while others charge a consultation fee with a Medicare rebate back. If a procedure such as a biopsy or removal is needed, that is usually quoted separately before anything goes ahead, so ask about billing when you book.
How long does a skin check take?
Around 15 to 20 minutes at many clinics, though it can run longer if you have a lot of moles to document or a spot needs attention on the day.
What happens if the doctor finds something?
The options range from photographing a spot so it can be monitored, to a small biopsy, to removing it. Many biopsied spots come back benign. If treatment is needed, the doctor will talk through what is involved and what it costs before anything is booked.
A skin check sits in that category of health admin that is easy to postpone because nothing hurts. Australia’s whole approach to skin cancer depends on people not postponing it. If you have never had a professional check, or you cannot remember your last one, that is probably answer enough on timing.
