Skin Cancer Screening and Diagnosis

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Skin cancer screening is important because it helps find unusual spots or changes on the skin before they become serious problems. When skin cancers like melanoma are discovered at an early stage, treating them is often easier and more successful.

Skin cancers that are caught early tend to be thinner and less likely to spread into deeper tissues or other parts of the body, too. This means removing them is usually easier and the outcomes are better.

Take Charge of Your Health

Talk to your primary care provider if you have questions or concerns about your skin or you have noticed an abnormality. UW Medicine Primary Care can help you get started with screening. Learn about Fred Hutch's relationship with UW Medicine.

How to Examine Your Skin

Doing a monthly self-exam of your skin is important so you can notice any changes and recognize new suspicious growths more easily.

Make an appointment with your primary care provider if:

  • You notice a change in the color, size, texture or appearance of a mole or skin lesion
  • You have bleeding, itching, inflammation or pain in a mole or lesion
  • You have another sign or symptom on your skin that is concerning to you

Other Changes to Look For

Other changes in your moles that you should be aware of include:

  • Sensation — Itching is the most common early symptom. Skin cancers are usually painless, but there can be tenderness and pain.
  • Size — A mole is suddenly bigger or continues to get bigger.
  • Spreading color — Melanomas can be a variety of colors, and the color may spread from the edge into the surrounding tissue.
  • Elevation — A flat or slightly raised mole grows higher very quickly.
  • Surrounding skin — The skin around a mole becomes red or develops colored blemishes or swelling.
  • Surface — A mole's surface changes from smooth to scaly, eroding and oozing. A crusty, ulcerated or bleeding mole is a sign of advanced disease.

How to Examine Your Skin for Melanoma

Melanoma is the most serious type of skin cancer, and it can spread quickly to other parts of the body. That’s why it is especially important to detect this type of skin cancer early, when treatment is most likely to be successful. Learn about melanoma warning signs and what exactly to look for.

View Melanoma Screening Guide

What to Expect at Your Skin Cancer Screening Appointment

When you come in for a screening, a physician will ask questions about your family health history. They’ll also ask about your sun exposure, any medicines you may be taking and ask other questions about your lifestyle and possible risk factors.

If you have had changes in a mole or a new spot on your skin, the physician will ask you more about it, such as when the change happened. They will also perform a physical exam and check the skin lesion, as well as check for any other suspicious moles or marks. 

Tools and Methods Used at Skin Cancer Screenings

  • Dermascope: Your provider might use an advanced tool like a dermatoscope, which is a handheld device that uses magnification and a special light to see structures and patterns within a mole.
  • Mole mapping: Involves taking images of your entire body to create a baseline of how moles and spots appear. Then, when you come back for visits, the physician can look back at these images to see if there have been any changes.

Skin Cancer Diagnosis

Dermatologists (physicians specialized in treating skin, hair and nails) are skilled at recognizing the many signs and symptoms of skin cancer during a physical exam. However, to know for certain if skin cancer is present, a sample of the affected skin must be taken and examined in a lab. This process is called a skin biopsy.

Common types of biopsies for skin cancer include:

  • Shave biopsy: A sterile razor blade is used to shave off the lesion
  • Punch biopsy: An instrument called a punch is used to remove a circle of tissue from the lesion
  • Excisional biopsy: A scalpel is used to remove the entire growth

After the skin sample is tested, the lab will send a report to the provider. If skin cancer is found, the lab report will provide details about the type of skin cancer it is. This information helps the provider personalize your care and recommend the best treatment options for you.

Sentinel Lymph Node Mapping and Biopsy

This is a procedure in which a radiolabeled substance and a blue dye are injected near your tumor. The substance, which contains a tiny amount of harmless radioactive material, flows through lymph ducts to the first lymph node or nodes, allowing your physician to see where cancer cells are likely to spread (sentinel nodes). Your surgeon can then remove only the nodes where the substance appears. They are then sent to a lab where a pathologist checks them for cancer.

Imaging Studies and Lab Tests

Your physician might recommend other tests or scans to learn more about your condition, especially if your tumor is deep or your lymph nodes are involved. These may include a computed tomography (CT) scan, chest X-ray, positron emission tomography (PET) scan, magnetic resonance imaging (MRI) scan or bone scan and tissue, or blood or urine tests.

If the Diagnosis is Basal or Squamous Cell Skin Cancer

These types of skin cancer usually do not spread beyond the skin. If a person is diagnosed with basal or squamous cell skin cancer, often the biopsy itself removes the entire tumor, so there is no need for more treatment.

If the Diagnosis is Melanoma

If the lab report shows the diagnosis is melanoma, there is a chance that it has spread to the lymph nodes or other parts of the body. To understand how advanced it is (called staging) more information or tests are needed. Read more about melanoma stages.

Skin Cancer Screening and Diagnosis FAQ

How often you need screenings is determined by your provider based on your personal risk factors. For example, if you have a family history of melanoma, you may need to come back more often. Talk to your primary care provider to find out how often you should be screened.

Yes. While sun exposure damages skin and is a primary cause of skin cancer, it is not the only reason why people develop it. No matter your level of risk, it is good to perform monthly skin self-checks. That’s because if there are changes to your skin, you’ll notice them early on, and can make an appointment to be examined by a physician.