Skin Cancer Screening Guidelines

Age-Based Screening Recommendations

The American Cancer Society recommends a cancer-related checkup including skin examination every three years for patients between ages 20 and 40, and yearly for anyone age 40 and older 1, 2, 3, 4
For patients ages 20-40, skin examination every 3 years as part of cancer-related checkup is recommended 1, 2, 3, 4
For patients ages 20-40, monthly self-examinations are recommended 5
For patients age 40 and older, annual skin examinations are recommended 1, 2, 3, 4
For patients age 40 and older, continue monthly self-examinations 5

High-risk patients should be referred to a dermatologist for monitoring and screening examinations at any age 2, 3
Familial melanoma syndrome is a high-risk criterion 1, 2, 3
First-degree relative with melanoma is a high-risk criterion 2, 3
Multiple atypical nevi is a high-risk criterion 7

The American Medical Association recommends annual skin examinations by a primary care physician for patients at moderately increased risk 1, 2, 3, 4
Moderately increased risk patients should discuss screening frequency with their physician and perform monthly self-examinations 1, 2, 3, 4

When evaluating whether to recommend dermatology referral, assess for ABCDE criteria for suspicious lesions: Asymmetry, Border irregularity, Color variation, Diameter >6mm, Evolution over time 7
When evaluating whether to recommend dermatology referral, assess for "Ugly duckling" sign: Moles that look different from surrounding moles 7
Melanomas can occur in non-sun-exposed areas, particularly in people with darker skin, who are often diagnosed at later stages 7

The USPSTF and Canadian Task Force on Preventive Health Care concluded there is insufficient evidence to recommend for or against routine screening for skin cancer in average-risk, asymptomatic individuals 4, 5, 6
Complete skin examinations detect melanoma 6.4 times more frequently than partial examinations 1, 2, 3