Screening
The US Preventive Services Task Force reports that there is insufficient evidence to assess the balance of benefits and harms of visual skin examination by a clinician to screen for skin cancer in asymptomatic adolescents and adults (i.e., without a suspicious skin lesion and not under surveillance because of a high risk for skin cancer).[82]
While there is no good evidence to support periodic screening in people prior to the development of squamous cell carcinoma (SCC), or in those who are not at high risk, most experienced clinicians recommend that a yearly total body skin examination should be performed in all at-risk patients, preferably by a dermatologist, particularly in those >50 years of age.
After the diagnosis of a first SCC, screening for new keratinocyte cancers (BCC or SCC) and for melanoma should be performed on at least an annual basis, with frequency adjusted based on individual risk.[83] Patients with a history of SCC should be counseled on skin self-examination and sun protection.
Solid organ transplant recipients
All solid organ transplant recipients should be reviewed by a dermatologist, risk-stratified by key risk factors (e.g., multiorgan transplant, pretransplant skin cancers, Fitzpatrick skin phototype, demographics, immunosuppression regimen type), and assigned to a screening timeline (every 3 or 6 months or annually).[84] Pretransplantation SCC is the strongest predictor of posttransplantation SCC. Actinic keratoses and viral warts at/before transplantation are also significantly associated with an increased risk of SCC.
Early identification and treatment of SCC leads to better outcomes, including smaller and less invasive tumors and fewer metastases.[15][84]
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