Skin cancer

Advise on sun protection and prevention

Screen increased-risk and high-risk patients

Clinical assessment of future risk of melanoma should take into account:⁶⁰

• patient’s age and sex
• history of previous melanoma or NMSC
• number of naevi (common and atypical)
• family history of melanoma
• skin and hair pigmentation
• response to sun exposure
• evidence of actinic skin damage.

There are no sufficiently well-validated risk models to assess the combined effects of all these factors.⁶³

Skin self-examination should be encouraged for high-risk individuals every three months and clinical examination every six months (B).^63,64

Table 9.4.1.1

Melanocytic skin cancer: Identifying risk

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Table 9.4.1.2

Melanocytic skin cancer: Preventive interventions

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Implementation

GPs over-excise pigmented lesions in people who are younger (aged <40 years) or female, in whom they excise more benign lesions.⁷⁵ GPs should be more suspicious of skin lesions in men aged >50 years.⁷⁵

Prevention advice

Opportunistic case finding

High-risk individuals aged ≥40 years should be examined for NMSC opportunistically (B). Skin self-examination should be encouraged for high-risk individuals (B). The most common preventable cause of NMSC is UV exposure. All people, especially children, should be advised to use protective measures when UV levels are ≥3 (A).

An RCT in Queensland showed that sunscreen applied daily reduces the incidence of melanoma and SCC in adults with a previous history of skin cancer.⁵⁸ In northern Australia and some parts of southern Australia, UV exposure is sufficiently high to require daily use of sunscreen. For daily information about UV levels visit the SunSmart widget

Table 9.4.2.1

Non-melanocytic skin cancer: Identifying risk

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Table 9.4.2.2

Non-melanocytic skin cancer: Preventive interventions

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