Most people, approximately 75%, check for skin cancer first by examining themselves and then going to their doctor for a second opinion and evaluation. Generally, the physician will examine the skin with the naked eye or if available, by dermascope, a hand-held magnifying glass with a special light, in an effort to accurately determine if there is some sort of skin cancer.
Currently, dermatologists and other primary care physicians mainly use visual (naked-eye) clinical evaluation to diagnose skin cancer. Physicians assess pigmented skin lesions using the “ABCDE” criteria, Asymmetry, Border irregularity, Color variation, Diameter, and Evolving. This is often followed by biopsy of suspected lesions to confirm if the tissue is cancerous.
However, this process is subjective and can result in missed melanomas. The ratio of benign lesions biopsied to melanomas confirmed that is highly variable, as high as 40 to 1 for dermatologists and as high as 80 to 1 for primary care physicians. In addition to their own vision, doctors sometimes use a dermascope, a hand-held magnifying glass with a light to illuminate the skin area, to decide whether a spot or wart merits a biopsy. This type of assessment is still subjective and can also result in missed skin cancers. Further analysis, such as biopsy, is still required to confirm the presence of cancerous tissue.
The effectiveness of these current procedures is dependent on the experience of the examiner, and errors in diagnosis can be fatal. Occasionally, cancers remain undetected, grow further and lead to a decrease in survival chances.