Skin cancer diagnosis goes beyond observing lesions

The melanoma is the most aggressive type of cancer skin. With high lethality, the incidence of the disease is low. In 2018, 6620 cases are estimated, according to the National Cancer Institute (INCA). But the data can be bigger.

That’s because taking a look at the wart or skin lesion is not enough to safely rule out skin cancer. Even if it is an expert look.

The claim comes from a review conducted by the University of Birmingham, England. The study had the participation of researchers from the Cochrane group, a global entity that brings together researchers, professionals and those interested in health topics.

The researchers involved evaluated patient care. For this, they used a practical method.

They presented the doctor with photos of spots, spots and skin lesions. Then, he should indicate the diagnosis, without further analysis.

Then the errors and successes were counted.

The findings indicate what, in fact, most health professionals already know. More attention during the consultation means better rates of early diagnosis.

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Diagnosis beyond observation

According to the review, 1 in 10 cases of melanoma cancer are not identified by the visual test. Even when performed by dermatology specialists.

Observing the skin is essential. Even doctors themselves encourage people to pay attention to their own skin and observe changes.

However, when the patient arrives at the office with an injury or spot, the ideal is to combine the diagnostic technologies.

That is, make that visual assessment and then use the most modern tactics that facilitate the confirmation of the previous diagnosis. Even if it is just to confirm that the patient is healthy.

The results provide valuable indications about the performance of professionals from different specialties and the correct management of patients with suspected skin cancer. That’s because several experts were part of the study.

According to the researchers, in general, dermatologists follow a responsible pattern. If there is a slight uncertainty about the risk of skin cancer, the patient is referred to specific tests or is instructed to be aware of the stain.

But this is not always the case when it comes to other medical professionals, such as general practitioners, pediatricians or other specialties, who tend to rely only on superficial analysis.

There are ways to alleviate the problem. Just a few more minutes in the consultation, a device that magnifies the skin surface – called a dermatoscope – and professionals trained to better interpret the results so that the diagnostic indexes improve.

What are the signs of skin cancer?

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About 1 in 4 cases of cancer is skin, according to the INCA. The disease is characterized by abnormal growth of skin cells and can be divided into two main groups: melanomas and carcinomas (or non-melanomas).

Carcinomas are the most common and represent 95% of malignant skin tumors. In general, the tissue presents rough regions or small wounds that do not hurt and do not heal.

As they are related to sun exposure, they usually appear in those most unprotected parts of the body, such as the face, ears, shoulders and arms.

The melanoma type is uncommon and represents, on average, 5% of cases. In addition to sun exposure, the genetic factor may have great relevance in the development of the disease.

Its manifestation is through dark spots or spots on the skin, which can appear on any part of the body. Even in those that hardly ever get the sun.

Information on the use of sunscreen, which circulates in campaigns and is part of the guidelines of doctors in general, aims to reduce cases of the disease. But in addition to avoiding the sun – or at least the intense exposure to it – it is necessary to look at the skin.

The specialists even have a simple rule to facilitate self-care and indicate the need to go to the dermatologist. It is called the ABCDE rule.

Pay attention to some aspects of the injury and seek a specialist when:

  • A – asymmetry: the spots or spots have different sides, not rounded or symmetrical;
  • B – irregular edges: there is a change in the texture of spots or spots, skin roughness or lack of uniformity;
  • C – color: the spots or stains change color or are not uniform in pigmentation;
  • D – diameter: spots and stains that are larger than 6mm;
  • E – evolution: brands that grow, proliferate, change color or appearance.

The tactic is very effective and has been maintained as a strategy to make it easier for people to maintain attention to their own health. In fact, there are a lot of people more and more attentive to the signals that the organism gives.

Along with the technological development that facilitates the performance of professionals, applications that are accessible to the general public have emerged that promise to facilitate self-examination. Just a photo of the stain or paint and, in a few minutes, the program gives an opinion on the possibility of cancer.

The developers say the idea is not to replace medical advice, but to help and facilitate self-care.

However, Cochrane researchers make reservations about the use of applications. They have a high chance of evaluating melanoma cancer with a false negative.

Not that it is necessary to uninstall the program. After all, it can help with various information.

But you need to take the developer’s own recommendation seriously and consult the experts – even if the app says it’s all right.

Read more: 11 tips to prevent cancer and fight risk factors

The two sides of technology in health

The applications work from algorithms and image comparison systems. It is like training the machine that can be quite accurate and effective in images compatible with cancer.

But the substitution of the human eye (capable of considering other factors involved, such as genetic inheritance) cannot be substituted.

The Cochrane study found that the false-positive rates generated by the programs have created unnecessary patient apprehension. They can even mislead the doctor, leading to invasive examinations and unnecessary surgeries.

In addition to the patient’s suffering, there is an increase in costs to health systems.

But the concern is also great in the case of false negatives for melanoma – which is the most aggressive cancer.

The applications have shown less efficiency when the objective is to indicate the risks, including in cases where the melanoma is diagnosed. That is, patients can receive a more promising assessment than, in fact, it is.

A professional look would be enough to resolve this misunderstanding. But these systems are accessible to the general population and often do not indicate the fact that they do not replace the doctor.

Thus, some people give up making an appointment and do not receive the proper referral.

So, what is the middle ground?

The Cochrane researchers themselves indicate the solution: using technologies in favor of health, enabling medical professionals from different fields to perform dermoscopy more frequently.

The exam significantly increases the visualization of specific points on the skin and allows a dermatologist to confirm the diagnosis. A fast process that can contribute a lot to the skin cancer scenario.

It is estimated that more than 171,000 people will be diagnosed with the disease in the 2018-2019 biennium, according to the INCA. With an early diagnosis, treatment becomes easier, faster and more effective, reducing risks to the patient.

In addition to paying more special attention to spots or spots, studies reinforce the need that in cases of uncertainty – even if it is very small – doctors in other areas need to refer the patient to a dermatologist.


Health research has helped patients and professionals to maintain or regain health in increasingly effective ways.

With a focus on prevention, the methods of evaluation, diagnosis and treatment are constantly developed, facilitating self-care and also the performance of the professional.

To keep your skin healthy, don’t forget the sunscreen and follow the Healthy Minute!

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