Skin Cancer Screening: Detecting Skin Cancer Early

The skin cancer screening of the statutory health insurance companies is a free program for the early detection and prevention of skin cancer. Use, procedure, possible disadvantages

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Skin Cancer Screening - Briefly Explained

  • In 2008 a nationwide, standardized skin cancer early detection program was launched: skin cancer screening.
  • It is aimed at all those with statutory health insurance from the age of 35.
  • The screening examination is voluntary and free of charge. It can be used every two years, i.e. every second calendar year.
  • The main goal is to discover various forms and precursors of skin cancer as early as possible. Then they are usually even easier to treat and more often curable.
  • The screening should also provide information about skin cancer prevention.
  • The investigation can have advantages and disadvantages. The fact that fewer people die of skin cancer as a result of the screening program has not yet been proven with certainty.

Important: Regardless of whether you take part in skin cancer screening, it is generally advisable to use suitable sun protection and to regularly check your skin for changes yourself. Anyone who discovers abnormalities should always have them clarified by a doctor as soon as possible. Such event-related examinations are usually covered by the health insurance company. They are not synonymous with skin cancer screening.

What skin changes is screening about?

The examination as part of skin cancer screening (sometimes also called skin screening) is intended to specifically record the preliminary stages and early stages of three important skin cancers:

  • malignant melanoma
  • Basal cell cancer
  • spinocellular carcinoma

Malignant melanoma is also called "black skin cancer". The tumor can run aggressively and form settlements, so-called metastases, at an early stage. Malignant melanoma therefore causes the majority of deaths from skin cancer.

Basal cell cancer and spinocellular carcinoma are also called "white skin cancer". They occur mainly in the elderly, are much less aggressive, and rarely metastasize.

Sometimes skin cancer can look something like a mole (also called a mole) or it can develop from an existing mole.

You can find out more about the signs, types and treatment of skin cancer here:
https://www.apotheken-umschau.de/Hautkrebs

Who can participate in skin cancer screening?

  • Participation is open to all those with statutory health insurance from the age of 35, i.e. from their 35th birthday.
  • From this age onwards, the screening examination can be used every two years, i.e. every second calendar year.

In individual cases, early detection examinations may be appropriate at a younger age or at shorter intervals. It is best to seek advice on this from your doctor's office.

Numerous health insurance companies have concluded special contracts with the Professional Association of German Dermatologists (BVDD). As part of these special contracts, the dermatologists taking part can also offer insured persons who are not yet 35 years of age free skin cancer screening.

Those who are privately insured can inquire about offers from their insurance company.

Which Doctors Do Skin Cancer Screenings?

The following doctors can offer skin cancer screening - provided they have taken part in a special training course and have received the relevant approval from the Association of Statutory Health Insurance Physicians:

  • Specialists in skin and venereal diseases (dermatologists)
  • General practitioners
  • Internists
  • general practitioners

Anyone interested in free skin cancer screening should ask their general practitioner or dermatologist about it. In some cases, doctors also offer examinations that patients have to pay for themselves.

If an abnormal result is found during the skin cancer screening, general practitioners, general practitioners and internists usually refer the matter to the dermatologist for a detailed investigation.

Preparation for the skin exam

You can do this in preparation to make the examination easier:

  • Remove nail polish from fingernails and toenails
  • Remove earrings and piercings
  • do not wear makeup
  • choose a practical hairstyle that allows an examination of the scalp

How does skin cancer screening work?

First, the patient's medical history is collected. This includes information on the state of health and previous illnesses. In addition, possible risk factors for skin cancer are determined.

The physical examination follows the preliminary talk. So that the doctor can look at the whole body, the patient must take off his or her clothing. All areas of the body are examined, including the scalp and skin folds. Because skin cancer, especially malignant melanoma, can occur anywhere on the skin, not just in areas that are exposed to the sun. For the examination, the doctor needs good lighting in the consulting room and a trained eye.

In addition, the patient receives tips on how to use the sun properly, i.e. how to prevent skin cancer.

The examination is part of a large-scale program and is carried out by the doctors according to established and verifiable quality standards. They not only use a standardized examination method, but also systematically document their results.

What happens if there is a suspicious finding?

If abnormal skin changes are found, it may be necessary to take a tissue sample to clarify the diagnosis. This is usually done by the dermatologist. The fact that an area of ​​skin is suspicious does not necessarily mean that it is cancer. A histological examination of the skin sample often reveals that the change was not malignant after all.

What are the disadvantages and risks?

  • Whether fewer people actually die from skin cancer as a result of skin cancer screening has not yet been clearly proven. There is still a need for research here.
  • Sometimes areas of skin suspected of being cancerous are removed. The subsequent tissue examination then shows that it was not cancer at all. For those affected, this may initially cause worries and fears that were unnecessary. A small scar can also remain on the skin.
  • It is conceivable that a skin cancer will be discovered and treated that would never have caused problems for the person concerned during their lifetime. Doctors call this overdiagnosis or overtherapy.
  • Despite all due care, it can happen that skin cancer is not detected during a screening examination.
  • Screening does not automatically protect against skin cancer. It only shows the current status. Rapidly growing tumors can also develop between two screening examinations, for example.
  • Critics of the screening fear that people may pay less attention to skin changes themselves and have them checked up in good time, and that they may also protect their skin less carefully from the sun - because the screening makes them feel less secure.

What does the cash register pay?

The statutory health insurance companies have been paying for skin cancer screening since 2008. It is a voluntary early diagnosis examination. Statutory insurance can take advantage of this every two years from the age of 35.

Numerous health insurance companies have concluded special contracts with the Professional Association of German Dermatologists (BVDD). As part of these special contracts, the dermatologists taking part can also offer insured persons who are not yet 35 years of age free skin cancer screening.

Regardless of this, the statutory health insurance usually pays the costs if you want to have a conspicuous area of ​​skin examined by a doctor, i.e. if there is a specific need for an examination. This is possible at any time. But this is not about skin cancer screening.

Which IGe services are often offered?

The health insurance companies usually only pay for the normal screening, some health insurance companies already pay it voluntarily before the 35th birthday. Further examinations for skin cancer early detection beyond the screening, which many dermatologists offer, are usually not accepted.

Such examinations or treatments, which do not belong to the catalog of services of the statutory health insurance, are referred to as "individual health services", or IGeL for short. They must be expressly requested by the patient, which the doctor must document in writing in a contract. The patient then pays for these IGeL services himself.

This includes the skin cancer screening examination with reflected light microscopy (i.e. the examination with a dermatoscope) as well as the computer-photographic reflected-light microscopic documentation of pigment marks.

Furthermore, the removal of benign, cosmetically annoying birthmarks, and the removal of age-related irregularities of the skin such as age warts, age spots and age-related blood sponges are usually not taken over.

Dr. Angela Unholzer

© W & B / private

Consulting expert

Dr. med. Angela Unholzer is a dermatologist with additional qualifications in allergology and dermatohistology. She completed her specialist training at the Dermatological University Clinic of the Ludwig Maximilians University in Munich and at the Clinic for Dermatology and Allergology at the Augsburg Clinic. At the latter clinic, she was senior physician in charge of the lighting department, the dermatological day clinic and the general dermatological outpatient department from 2006 to 2012. She then worked in a practice near Augsburg. She has had her own practice in Donauwörth since 2014.

Swell:

- Minor I: Dual Dermatology Series, 8th edition, Stuttgart Thieme Verlag 2016

- Guideline of the Federal Joint Committee on the Early Detection of Cancer Diseases (Cancer Early Detection Guideline) in the version of June 18, 2009, last amended on July 19, 2018. Online: https://www.g-ba.de/downloads/62- 492-1811 / KFE-RL_2018-07-19_iK-2019-04-18.pdf (accessed 09/2019)

- Guideline program oncology (German Cancer Society, German Cancer Aid, AWMF): S3 guideline prevention of skin cancer, long version 1.1, 2014

- Guideline program oncology (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF): S3 guideline for diagnosis, therapy and follow-up care of melanoma, version 3.1, 2018

- Patient information.de: skin cancer prevention. Online: https://www.patienten-information.de/kurzinformationen/fruehicherung/hautkrebspraevention (as of July 2016)

- Dermatological Oncology Working Group (ADO). Online: http://ado-homepage.de/ (accessed on 08/2019)

- Homepage of the German Cancer Aid and the Dermatological Prevention Working Group for the prevention of skin cancer. Online: www.hautkrebs-screening.de (accessed 08/2019)

Important NOTE:

This article is for general guidance only and is not intended to be used for self-diagnosis or self-treatment. It cannot replace medical advice. Please understand that we do not answer individual questions.

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