Mole screening - Jonathan Bowling, Cadogan Clinic

How to choose a mole screening / skin cancer screening clinic

Skin cancer rates are rising across the UK faster than any other form of cancer. Missing the opportunity to detect and treat an early melanoma can be life threatening. If you are considering skin cancer screening, ensure you seek the opinion of a doctor suitably trained in diagnosing skin cancers, typically a dermatologist. Recent medical reports highlight that skin cancers are being missed by clinics where the screening is performed by non-medically qualified staff.

A few questions to help choose where to go…

Ask the clinic...

1. Will I be charged per mole examined?
No, a skin expert will routinely examine all of your moles as part of their examination. However this question will easily separate clinics with legitimate skin experts from those trying to make money out of health screening. Many high street clinics have a policy of charging per mole examined, reflecting their lack of expertise onsite.

2. When are the results available?
Immediately. A skin cancer expert can give you the results at your examination. Many high street clinics advertise results in 24-48 hours. This practise simply highlights the lack of expertise onsite, as an opinion needs to be sought from an external third party.

3. How many melanomas have they diagnosed in the last year?
This will help to clarify whether they are used to diagnosing and managing skin cancer including melanoma. A benchmark would be that clinicians working in a busy skin cancer unit would see approximately 100 melanomas in a year.

Ask the examiner…

1. What are your medical qualifications?
This may sound obvious but your ‘doctor’ should actually be a qualified doctor with specific training in skin cancer diagnosis.
Be aware that although someone may have worked in a skin cancer unit there is no guarantee that they have been fully trained or involved in the diagnosis of melanoma.

2. How many melanomas have you personally diagnosed?
100’s. Again this may sound obvious, however dermatologists may diagnose melanoma almost daily and will be expert in recognising the many ways in which melanoma presents. Unfortunately high street clinics may be staffed by individuals who have never seen a melanoma.

3. What do you do if you find a suspicious mole?
The options would typically be:
For low risk lesions - Photography for future review
For high risk lesions - surgical removal of the mole for microscopic examination

Importantly clarify where and by whom the treatment would be undertaken by. The Department of Health’s NICE guidance on skin cancer dictates that all suspicious moles should only be removed by experts who are members of the local skin cancer multidisciplinary team. By seeing an expert from the outset any delay treatment can be avoided.

3. Do you use dermoscopy?
Yes they should. Dermoscopy is the diagnostic technique taught by dermatologists which increases accuracy for diagnosing melanoma. Ensure whoever is examining your skin is an expert in dermoscopy. Failing to use dermoscopy increases the likelihood of unnecessary surgery and of course the scars that result.

Is it easy to screen for / detect melanoma?

Unfortunately there are no simple screening test to detect melanoma. Diagnosis depends upon the clinical skill of the examiner, which is complicated by the many ways in which melanoma shows itself. Therefore in order to successfully detect melanoma in its early stages you need to see a qualified skin cancer expert. Unfortunately we still do not have a good treatment for advanced melanoma therefore early detection could be the difference between life and death.

The Solution

Visit a MyDermatologist member, the global network of skin cancer specialists and experts across the UK, Europe and Australia, dedicated to improving skin cancer diagnosis. Click on MyDermatologist.org for details.

Jonathan Bowling

One of the founders of the MyDermatologist network, Dr Jonathan Bowling is a Consultant Dermatologist at the Cadogan Clinic in London (www.cadoganclinic.com), the only UK clinic able to offer same-day skin cancer testing, and at the University of Oxford Skin Cancer Unit.