We don’t all need regular skin cancer screening – but you can know your risk and check yourself

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Australia has one of the highest skin cancer rates globally, with nearly 19,000 Australians diagnosed with invasive melanoma – the most lethal type of skin cancer – each year.

While advanced melanoma can be fatal, it is highly treatable when detected early.

But Australian clinical practice guidelines and health authorities do not recommend screening for melanoma in the general population.

Given our reputation as the skin cancer capital of the world, why isn’t there a national screening program? Australia currently screens for breast, cervical and bowel cancer and will begin lung cancer screening in 2025.

It turns out the question of whether to screen everyone for melanoma and other skin cancers is complex. Here’s why.

Pixel-Shot/Shutterstock

The current approach

On top of the 19,000 invasive melanoma diagnoses each year, around 28,000 people are diagnosed with in-situ melanoma.

In-situ melanoma refers to a very early stage melanoma where the cancerous cells are confined to the outer layer of the skin (the epidermis).

Instead of a blanket screening program, Australia promotes skin protection, skin awareness and regular skin checks (at least annually) for those at high risk.

About one in three Australian adults have had a clinical skin check within the past year.

clinician checks the back of a young man with red hair and freckles in health office
Those with fairer skin or a family history may be at greater risk of skin cancer. Halfpoint/Shutterstock

Why not just do skin checks for everyone?

The goal of screening is to find disease early, before symptoms appear, which helps save lives and reduce morbidity.

But there are a couple of reasons a national screening program is not yet in place.

We need to ask:

1. Does it save lives?

Many researchers would argue this is the goal of universal screening. But while universal skin cancer screening would likely lead to more melanoma diagnoses, this might not necessarily save lives. It could result in indolent (slow-growing) cancers being diagnosed that might have never caused harm. This is known as “overdiagnosis”.

Screening will pick up some cancers people could have safely lived with, if they didn’t know about them. The difficulty is in recognising which cancers are slow-growing and can be safely left alone.

Receiving a diagnosis causes stress and is more likely to lead to additional medical procedures (such as surgeries), which carry their own risks.

2. Is it value for money?

Implementing a nationwide screening program involves significant investment and resources. Its value to the health system would need to be calculated, to ensure this is the best use of resources.

Narrower targets for better results

Instead of screening everyone, targeting high-risk groups has shown better results. This focuses efforts where they’re needed most. Risk factors for skin cancer include fair skin, red hair, a history of sunburns, many moles and/or a family history.

Research has shown the public would be mostly accepting of a risk-tailored approach to screening for melanoma.

There are moves underway to establish a national targeted skin cancer screening program in Australia, with the government recently pledging $10.3 million to help tackle “the most common cancer in our sunburnt country, skin cancer” by focusing on those at greater risk.

Currently, Australian clinical practice guidelines recommend doctors properly evaluate all patients for their future risk of melanoma.

Looking with new technological eyes

Technological advances are improving the accuracy of skin cancer diagnosis and risk assessment.

For example, researchers are investigating 3D total body skin imaging to monitor changes to spots and moles over time.

Artificial intelligence (AI) algorithms can analyse images of skin lesions, and support doctors’ decision making.

Genetic testing can now identify risk markers for more personalised screening.

And telehealth has made remote consultations possible, increasing access to specialists, particularly in rural areas.

Check yourself – 4 things to look for

Skin cancer can affect all skin types, so it’s a good idea to become familiar with your own skin. The Skin Cancer College Australasia has introduced a guide called SCAN your skin, which tells people to look for skin spots or areas that are:

1. sore (scaly, itchy, bleeding, tender) and don’t heal within six weeks

2. changing in size, shape, colour or texture

3. abnormal for you and look different or feel different, or stand out when compared to your other spots and moles

4. new and have appeared on your skin recently. Any new moles or spots should be checked, especially if you are over 40.

If something seems different, make an appointment with your doctor.

You can self-assess your melanoma risk online via the Melanoma Institute Australia or QIMR Berghofer Medical Research Institute.

H. Peter Soyer, Professor of Dermatology, The University of Queensland; Anne Cust, Professor of Cancer Epidemiology, The Daffodil Centre and Melanoma Institute Australia, University of Sydney; Caitlin Horsham, Research Manager, The University of Queensland, and Monika Janda, Professor in Behavioural Science, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • The Comfort Zone – by Kristen Butler

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    Are you sitting comfortably? Then we’ll begin. Funny, how being comfortable can be a good starting point, then we are advised “You have to get out of your comfort zone”.

    And yet, when we think of our personal greatest moments in life, they were rarely uncomfortable moments. Why is that?

    Kristen Butler wants us to resolve this paradox, with a reframe:

    The comfort zone? That’s actually the “flow” zone.

    Just as “slow and steady wins the race”, we can—like the proverbial tortoise—take our comfort with us as we go.

    The discomfort zone? That’s the stress zone, the survival zone, the “putting out fires” zone. From the outside, it looks like we’re making a Herculean effort, and perhaps we are, but is it actually so much better than peaceful consistent productivity?

    Butler writes in a way that will be relatable for many, and may be a welcome life-ring if you feel like you’ve been playing catch-up for a while.

    Is she advocating for complacency, then? No, and she discusses this too. That “complacency zone” is really the “burnout zone” after being in the “survival zone” for too long.

    She lays out for us, therefore, a guide for growing in comfort, expanding the comfort zone yes, but by securely pushing it from the inside, not by making a mad dash out and hoping it follows us.

    Bottom line: if you’ve been (perhaps quietly) uncomfortable for a little too long for comfort, this book can reframe your approach to get you to a position of sustainable, stress-free growth.

    Click here to check out The Comfort Zone, and start building yours!

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  • Sesame Oil vs Almond Oil – Which is Healthier?

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    Our Verdict

    When comparing sesame oil to almond oil, we picked the almond.

    Why?

    We were curious about this one! Were you, or were you confident? You see, almonds tend to blow away all the other nuts with their nutritional density, but they’re far from the oiliest of nuts, and their greatest strengths include their big dose of protein and fiber (which don’t make it into the oil), vitamins (most of which don’t make it into the oil) and minerals (which don’t make it into the oil). So, a lot will come down to the fat profile!

    On which note, looking at the macros first, it’s 100% fat in both cases, but sesame oil has more saturated fat and polyunsaturated fat, while almond oil has more monounsaturated fat. Since the mono- and poly-unsaturated fats are both healthy and each oil has more of one or the other, the deciding factor here is which has the least saturated fat—and that’s the almond oil, which has close to half the saturated fat of sesame oil. As an aside, neither of them are a source of omega-3 fatty acids.

    In terms of vitamins, there’s not a lot to say here, but “not a lot” is not nothing: sesame oil has nearly 2x the vitamin K, while almond oil has 28x the vitamin E*, and 2x the choline. So, another win for almond oil.

    *which is worth noting, not least of all because seeds are more widely associated with vitamin E in popular culture, but it’s the almond oil that provide much more here. Not to get too distracted into looking at the values of the actual seeds and nuts, almonds themselves do have over 102x the vitamin E compared to sesame seeds.

    Now, back to the oils:

    In the category of minerals, there actually is nothing to say here, except you can’t get more than the barest trace of any mineral from either of these two oils. So it’s a tie on this one.

    Adding up the categories makes for a clear win for almond oil!

    Want to learn more?

    You might like to read:

    Avocado Oil vs Olive Oil – Which is Healthier?

    Take care!

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  • Singledom & Healthy Longevity

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Statistically, those who live longest, do so in happy, fulfilling, committed relationships.

    Note: happy, fulfilling, committed relationships. Less than that won’t do. Your insurance company might care about your marital status for its own sake, but your actual health doesn’t—it’s about the emotional safety and security that a good, healthy, happy, fulfilling relationship offers.

    We wrote about this here:

    Only One Kind Of Relationship Promotes Longevity This Much!

    But that’s not the full story

    For a start, while being in a happy fulfilling committed relationship statistically adds healthy life years, being in a relationship that falls short of those adjectives certainly does not. See also:

    Relationships: When To Stick It Out & When To Call It Quits

    But also, life satisfaction steadily improves with age, for single people (the results are more complicated for partnered people—probably because of the range of difference in quality of relationships). At least, this held true in this large (n=6,188) study of people aged 40–85 years:

    ❝With advancing age, partnership status became less predictive of loneliness and the satisfaction with being single increased. Among later-born cohorts, the association between partnership status and loneliness was less strong than among earlier-born cohorts. Later-born single people were more satisfied with being single than their earlier-born counterparts.❞

    Source: The Changing Relationship Between Partnership Status and Loneliness: Effects Related to Aging and Historical Time

    Note that this does mean that while life satisfaction indeed improves with age for single people, that’s a generalized trend, and the greatest life satisfaction within this set of singles comes hand-in-hand with being single by choice rather than by perceived obligation, i.e., those who are “single and not looking” will generally be the most content, and this contentedness will improve with age, but for those who are “single and looking”, in that case it’s the younger people who have it better, likely due to a greater sense of having plenty of time.

    For that matter, gender plays a role; this large survey of singles found that (despite the popular old pop-up ads advising that “older women in your area are looking to date”), in reality older single women were the least likely to actively look for a partner:

    See: A Profile Of Single Americans

    …which also shows that about half of single Americans are “not looking”, and of those who are, about half are open to a serious relationship, though this is more common under the age of 40, while being over the age of 40 sees more people looking only for something casual.

    Take-away from this section: being single only decreases life satisfaction if one doesn’t enjoy being single, and even then, and increases it if one does enjoy being single.

    But that’s about life satisfaction, not longevity

    We found no studies specifically into longevity of singledom, only the implications that may be drawn from the longevity of partnered people.

    However, there is a lot of research that shows it’s not being single that kills, it’s being socially isolated. It’s a function of neurodegeneration from a lack of conversation, and it’s a function of what happens when someone slips in the shower and is found a week later. Things like that.

    For example: Is Living Alone “Aging Alone”? Solitary Living, Network Types, and Well-Being

    What if you are alone and don’t want to be?

    We’ve not, at time of writing, written dating advice in our Psychology Sunday section, but this writer’s advice is:don’t even try.

    That’s not nihilism or even cynicism, by the way; it’s actually a kind of optimism. The trick is just to let them come to you.

    (sample size of one here, but this writer has never looked for a relationship in her life, they’ve always just found me, and now that I’m widowed and intend to remain single, I still get offers—and no, I’m not a supermodel, nor rich, nor anything like that)

    Simply: instead of trying to find a partner, just work on expanding your social relationships in general (which is much easier, because the process is something you can control, whereas the outcome of trying to find a suitable partner is not), and if someone who’s right for you comes along, great! If not, then well, at least you have a flock of friends now, and who knows what new unexpected romance may lie around the corner.

    As for how to do that,

    How To Beat Loneliness & Isolation

    Take care!

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  • How To Stay Alive (When You Really Don’t Want To)

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    How To Stay Alive (When You Really Don’t Want To)

    A subscriber recently requested:

    ❝Request: more people need to be aware of suicidal tendencies and what they can do to ward them off❞

    …and we said we’d do that one of these Psychology Sundays, so here we are, doing it!

    First of all, we’ll mention that we did previously do a main feature on managing depression (in oneself or a loved one); here it is:

    The Mental Health First Aid That You’ll Hopefully Never Need

    Now, not all depression leads to suicidality, and not all suicide is pre-empted by depression, but there’s a large enough crossover that it seems sensible to put that article here, for anyone who might find it of use, or even just of interest.

    Now, onwards, to the specific, and very important, topic of suicide.

    This should go without saying, but some of today’s content may be a little heavy.

    We invite you to read it anyway if you’re able, because it’s important stuff that we all should know, and not talking about it is part of what allows it to kill people.

    So, let’s take a deep breath, and read on…

    The risk factors

    Top risk factors for suicide include:

    • Not talking about it
    • Having access to a firearm
    • Having a plan of specifically how to commit suicide
    • A lack of social support
    • Being male
    • Being over 40

    Now, some of these are interesting sociologically, but aren’t very useful practically; what a convenient world it’d be if we could all simply choose to be under 40, for instance.

    Some serve as alarm bells, such as “having a plan of specifically how to commit suicide”.

    If someone has a plan, that plan’s never going to disappear entirely, even if it’s set aside!

    (this writer is deeply aware of the specifics of how she has wanted to end things before, and has used the advice she gives in this article herself numerous times. So far so good, still alive to write about it!)

    Specific advices, therefore, include:

    Talk about it / Listen

    Depending on whether it’s you or someone else at risk:

    • Talk about it, if it’s you
    • Listen attentively, if it’s someone else

    There are two main objections that you might have at this point, so let’s look at those:

    “I have nobody to talk to”—it can certainly feel that way, sometimes, but you may be surprised who would listen if you gave them the chance. If you really can’t trust anyone around you, there are of course suicide hotlines (usually per area, so we’ll not try to list them here; a quick Internet search will get you what you need).

    If you’re worried it’ll result in bad legal/social consequences, check their confidentiality policy first:

    • Some hotlines can and will call the police, for instance.
    • Others deliberately have a set-up whereby they couldn’t even trace the call if they wanted to.
      • On the one hand, that means they can’t intervene
      • On the other hand, that means they’re a resource for anyone who will only trust a listener who can’t intervene.

    “But it is just a cry for help”—then that person deserves help. What some may call “attention-seeking” is, in effect, care-seeking. Listen, without judgement.

    Remove access to firearms, if applicable and possible

    Ideally, get rid of them (safely and responsibly, please).

    If you can’t bring yourself to do that, make them as inconvenient to get at as possible. Stored securely at your local gun club is better than at home, for example.

    If your/their plan isn’t firearm-related, but the thing in question can be similarly removed, remove it. You/they do not need that stockpile of pills, for instance.

    And of course you/they could get more, but the point is to make it less frictionless. The more necessary stopping points between thinking “I should just kill myself” and being able to actually do it, the better.

    Have/give social support

    What do the following people have in common?

    • A bullied teenager
    • A divorced 40-something who just lost a job
    • A lonely 70-something with no surviving family, and friends that are hard to visit

    Often, at least, the answer is: the absence of a good social support network

    So, it’s good to get one, and be part of some sort of community that’s meaningful to us. That could look different to a lot of people, for example:

    • A church, or other religious community, if we be religious
    • The LGBT+ community, or even just a part of it, if that fits for us
    • Any mutual-support oriented, we-have-this-shared-experience community, could be anything from AA to the VA.

    Some bonus ideas…

    If you can’t live for love, living for spite might suffice. Outlive your enemies; don’t give them the satisfaction.

    If you’re going to do it anyway, you might as well take the time to do some “bucket list” items first. After all, what do you have to lose? Feel free to add further bucket list items as they occur to you, of course. Because, why not? Before you know it, you’ve postponed your way into a rich and fulfilling life.

    Finally, some gems from Matt Haig’s “The Comfort Book”:
    • “The hardest question I have been asked is: “How do I stay alive for other people if I have no one?” The answer is that you stay alive for other versions of you. For the people you will meet, yes, but also the people you will be.”
    • “Stay for the person you will become”
    • “You are more than a bad day, or week, or month, or year, or even decade”
    • “It is better to let people down than to blow yourself up”
    • “Nothing is stronger than a small hope that doesn’t give up”
    • “You are here. And that is enough.”

    You can find Matt Haig’s excellent “The Comfort Book” on Amazon, as well as his more well-known book more specifically on the topic we’ve covered today, “Reasons To Stay Alive“.

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  • In Praise of Slowness – by Carl Honoré

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    This isn’t just about “taking the time to smell the roses” although yes, that too. Rather, it’s mostly about looking at what drives us to speed everything up in the first place, and correcting where appropriate.

    If your ancestors had time to eat fruit and lie in the sun, then why, with all of modern technology now available, are you harangued 16+ hours a day by the pressures of universally synchronized timepieces?

    Honoré places a lot of the blame squarely on the industrial revolution; whereas previously our work would be limited by craftsmen who take a year to complete something, or the pace of animals in a field, now humans had to keep up with the very machines that were supposed to serve us—and it’s only got worse from there.

    This book takes a tour of many areas affected by this artificial “need for speed”, and how it harms not just our work-life balance, but also our eating habits, the medical attention we get, and even our love lives.

    The prescription is deceptively simple, “slow down”. But Honoré dedicates the final three chapters of the book to the “how” of this, when of course there’s a lot the outside world will not accommodate—but where we can slow down, there’s good to be gained.

    Bottom line: if you’ve ever felt that you could get all of your life into order if you could just pause the outside world for a week or two, this is the book for you.

    Click here to check out In Praise of Slowness, and make time for what matters most!

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  • Strawberries vs Raspberries – Which is Healthier?

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    Our Verdict

    When comparing strawberries to raspberries, we picked the raspberries.

    Why?

    They’re both very respectable fruits, of course! But it’s not even close, and there is a clear winner here…

    In terms of macros, the biggest difference is that raspberries have moderately more carbs, and more than 3x the fiber. Technically they also have 2x the protein, but that’s a case of “two times almost nothing is still almost nothing”. All in all, and especially for the “more than 3x the fiber” (6.5g/100g to strawberries’ 2g/100g), this one’s an easy win for raspberries.

    When it comes to vitamins, strawberries have more vitamin C, while raspberries have more of vitamins A, B1, B2, B3, B5, B6, E, K, and choline. Another clear and easy win for raspberries.

    In the category of minerals, guess what, raspberries win this hands-down, too: strawberries are higher in selenium, while raspberries have more calcium, copper, iron, magnesium, manganese, phosphorus, and zinc.

    Adding up all the individual wins (all for raspberries), it’s not hard to say that raspberries win the day. Still, of course, enjoy either or both; diversity is good!

    Want to learn more?

    You might like to read:

    From Apples to Bees, and High-Fructose Cs: Which Sugars Are Healthier, And Which Are Just The Same?

    Take care!

    Don’t Forget…

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    Learn to Age Gracefully

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