Skin cancer screening is an examination that is performed on as many people as possible in order to detect skin cancer at an early stage and to be able to treat it subsequently. In Germany, the statutory health insurance companies have been offering a nationwide skin cancer screening program since July 1, 2008, as the number of skin cancer cases in Germany has risen sharply in recent years (to over 230,000 people per year throughout Germany). Every legally insured person over the age of 35 is entitled to skin cancer screening.
Every two years the examination can be carried out by the family doctor or dermatologist. Patients with an increased risk of developing skin cancer should take advantage of the preventive care earlier. The preventive examination for early detection of skin cancer is therefore advisable, as it allows a cure in almost all cases.
For example, early precursors of skin cancer should be detected by the screening program in order to improve the chances of cure and to ensure that as many people as possible do not develop skin cancer in the first place. The three most common skin cancers are spinocellular carcinoma, basal cell carcinoma (basalioma) and malignant melanoma. The first two forms are often referred to in the vernacular as “white” or “light” skin cancer to distinguish them from malignant melanoma or “black” skin cancer.
The white skin cancer (spinocellular carcinoma and basal cell carcinoma) occurs mainly in older people. They show a mostly slow and less aggressive growth and only very rarely form metastases (scattered cells) in other parts of the body. Nevertheless, like a malignant tumor, they can damage the surrounding tissue and penetrate into the surrounding bone, which is why they are sometimes referred to as partially malignant or semimalignant skin cancers.
The greatest risk factor for white skin cancer is the long-term exposure of the affected skin region to sunlight. In contrast to malignant melanoma, the tumors are not caused by frequent sunburns, but by direct exposure of the skin to UV rays. For this reason, the majority of basal cell cancers are located in the facial region: especially lips, nose and auricles are affected.
The black skin cancer (malignant melanoma) is the most feared form of skin cancer. It is very aggressive and forms early metastases in other parts of the body, which is associated with a high mortality rate. Every year, about 20,000 people in Germany develop malignant melanoma and about 15 percent of those affected die from the disease in the same year.
Exposure to sunlight is the most important risk factor for skin cancer because the sun’s UV radiation damages various skin cells and can lead to their degeneration. However, exposure to artificial UV radiation (for example in a tanning salon) can also lead to cell damage over the years and thus increase the risk of skin cancer. It has been proven that every sunburn, which often affects people with light skin, increases the risk of skin cancer. People who have a high number of large congenital moles also have an increased risk of skin cancer. Other risk factors for skin cancer are genetic predisposition (cancer in the family), environmental factors (for example occupational exposure to the chemical substance arsenic) and immunosuppression (weakened body defenses) by other diseases or drugs.
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