Skin cancer: Do you routinely
examine your patients?
by Dornechia George Carter, MD, FAAD
ome 331,530 Americans are projected to
be diagnosed with breast cancer in 2019.1
Another 174,650 men will be diagnosed
with prostate cancer,2 and colon cancer is
diagnosed in 1 of every 22 women, and 1 in
24 of men.3 These are important statistics
to bear in mind when doing your patients’
annual physicals, taking care to cover a
broad review of systems and build in all age-appropriate
screenings. But what about the largest organ of the body,
the skin? Collectively, basal cell carcinoma, squamous
cell carcinoma, and melanoma are diagnosed in more
than 3 million patients annually in the United States.
Twenty percent of the American population—one in five
Americans—is expected to receive a diagnosis of skin
cancer in their lifetime.4 Melanoma, which affects more
than 192,000 lives per year, has doubled in incidence
6 Dallas Medical Journal June 2019
overall since the 1970s; in the same period, incidence has
increased by 800% in women alone, likely attributable to
indoor tanning trends.4 Most deaths from skin cancer occur
due to melanoma, leading to the loss of nearly 20 lives
daily—more than 7,000 per year.4 Skin cancer is the most
common type of cancer; however, in most cases, it is quite
curable if located and treated early.4 And the diagnostic
tool? It is simple, easy, inexpensive, and high yield: a
complete physical exam.
Is skin cancer on your radar for your well checks—both
pediatric and adult? Do you routinely ask patients about
suspicious-appearing or changing moles? A skin exam
should be an integral part of everyone’s annual well checkup,
only takes a minute or two, and requires no special
tools to complete. Anticipatory guidance should include
use of sunscreen rated SPF 30 or higher; use of protective
clothing, like hats, UPF-rated clothing, sunglasses; and
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