Skin Cancer Awareness Month Focuses On People Of Color
SPRING HILL, Fla. â For John Powell, skin cancer is more than a diagnosis he was first given in 1995. Since then, it’s become a way of life for him.
âDoc took one off my back and another melanoma she took off about three weeks ago off the back of my arm,â he said. He wears sunscreen like most people wear coats in the winter. It’s simply a matter of survival in the Florida sun.
âIt is especially if Iâm in a rush or I get busy doing something,â Powell said. âYou have to be ever vigilant.â
Part of that vigilance is getting his skin evaluated at least twice a year.
Bay News 9 reporter Trevor Pettiford took the time to get his skin checked to by dermatologist Dr. Lisa Nyanda at Advanced Dermatology in Spring Hill, and learn some important and disturbing information about African-Americans and skin cancer.
âThe unfortunate thing is, patients with skin of color typically tend to go undiagnosed and they tend to be discovered later as far as advanced stages of skin cancer,â Dr. Nyanda said. âThe danger in that can be life threatening. So we know that melanomas can occur in African Americans and when it does occur in darker skin tones, it tends to be more aggressive and definitely more deadly.â
âWe can tell them to use sunscreen, seek shade, wear hats, get their routine skin examinations, but they just donât do it,â she said. âThatâs why Iâm here.â
Alternatives To Mobile Health Apps
Early detection of skin cancer could be significantly improved by launching a population screening program, but this is unlikely to become common due to the high costs and lack of evidence on harms and benefits . As the main risk factors for skin cancer like indoor tanning or ultraviolet exposure are, in large part, preventable , primary prevention and awareness campaigns could have a better cost-benefit ratio than early detection . These campaigns are a way for the general public to proactively adopt preventive behaviors and possibly learn how to recognize suspicious skin lesions they seemed to have resulted in better sun protection behavior . On the other hand, this success can be reversed if these awareness efforts are not continuous and they do not solve the shortages or difficulties in access to high-quality skin checks.
Development Of The Skinvision App Service
The history of the SkinVision app service is shown in Table 1. It went through several upgrades throughout its history, modifying the camera, the algorithm and its evaluation, type of lesions analyzed, and communication of the algorithm result to its user. One of the major initial challenges was related to image acquisition. In the beginning, there was no filter on the images sent for analyses, which meant that a significant proportion of the pictures taken by users was of insufficient quality to be analyzed by the disease classification algorithm or did not even contain a lesion to be analyzed. Since version 3 of the SkinVision app , a special camera module has been embedded, which only lets the camera take a photo after certain minimal quality conditions are met. Compared to unfiltered images taken with a standard smartphone camera, the camera module reduces the number of blurry photos by about 52% on an average . Altogether, improvements in the camera module and the algorithm pipeline led to a reduction in the number of assessments that failed to produce a risk rating, from 26% in 2016 to 2% in 2018 on an average.
aNew features include a dynamic grey threshold to differentiate between normal skin and lesion and a feature that prevents taking pictures without uniform luminosity.
aAfter incorporating answers into a questionnaire about the skin lesion.
bManuscript under peer review . For more details on these results, see Multimedia Appendix 1.
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Skin Cancer Apps Cannot Be Relied Upon For Accurate Results Study Finds
Smartphone apps designed to detect the risk of skin cancer are poorly regulated and frequently cannot be relied upon to produce accurate results, according to a new analysis.
Researchers based in the University of Birminghams Institute of Applied Health Research, in collaboration with the Centre of Evidence-Based Dermatology at the University of Nottingham, have analysed a series of studies produced to evaluate the accuracy of six different apps.
Their results, published in The BMJ, reveal a mixed picture, with only a small number of studies showing variable and unreliable test accuracy among the apps evaluated.
They found the apps may cause harm from failure to identify potentially deadly skin cancers, or from over-investigation of false positive results such as removing a harmless mole unnecessarily.
Lead researcher, Dr Jac Dinnes, from the Institute of Applied Health Research, said: This is a fast-moving field and its really disappointing that there is not better quality evidence available to judge the efficacy of these apps.
It is vital that healthcare professionals are aware of the current limitations both in the technologies and in their evaluations.
But the systems for generating and implementing evidence have not yet met the specific challenges, they added.
The study looked at nine different applications and found evidence for accuracy was lacking.
Umskincheck Is A Free Mobile Application Intended For Skin Cancer Self
UMSkinCheck is free mobile application intended for skin cancer self exam and surveillance that allows users to complete and store a full body photographic library, track detected moles/lesions, download informational videos and literature and locate a skin cancer specialist.
A skin cancer self exam is used to identify suspicious moles or lesions that may be cancer or growths that may develop into skin cancer . Individuals who are at a high risk of skin cancer are encouraged to perform frequent skin self exams and to have full body photographic surveys taken by professional photographers. Now with UMSkinCheck patients will be able to complete a full skin cancer self exam and survey, track and create a history of moles and lesions all through a handheld mobile device.
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This Article Has A Correction Please See:
- Accepted 17 December 2019
How Your Phone Can Help You Spot Skin Cancer
Telemedicine is a growing field, and skin care is not to be left out: Over the last several years, a handful of skin cancer detection apps popped up allowing you to analyze your skin with your smartphone and artificial intelligence algorithms.
Some send photos to a dermatologist, some provide instant feedback and others offer helpful reminders about self-checking your skin and scheduling a doctor’s appointment.
Here are a few you can download on iOS and Android.
Miiskin uses hi-res digital photography to capture magnified photos of moles on your skin.
These Apps Are Available For Both Apple And Android Phones
- Miiskin. Miiskin is a paid “aka premium” app. It uses high-res photography to take photos of large parts of your body. The app allows the user to compare individual moles over time to detect changes.
- MoleMapper. MoleMapper is the result of a cancer biologist’s efforts to help his wife. Oregon Health & Science University collaborated with Apple and Sage Bionetworks to develop this app. It’s available at no cost. OHSU guides physicians to help monitor suspicious lesions without monthly in-person visits.
- MoleScope. Users must purchase a device that attaches to their smartphone. Photos taken with the attachment are sent to a dermatologist for an online opinion.
- SkinVision. A board of dermatologists developed this paid app. The app uses a deep learning algorithm to analyze your mole photo and assess whether it is high-risk within a minute.
- UMSkinCheck. This University of Michigan Medical School app is free. UMSkinCheck allows users to do a complete skin cancer exam and track changes over time. This app provides helpful advice on how to perform a skin exam. The app stores your baseline photos for comparison. It also furnishes prompts to remind you to check your skin regularly.
Early detection of suspicious moles saves lives and helps prevent disfigurement because a patient waited too long to see a dermatologist. Be sure to incorporate a monthly skin self-exam into your routine.
How Skin Cancer Apps Can Help You
Do you forget to check your skin for skin cancer? Do you rely on your memory to decide whether a mole has changed? If you answered yes to either question, theres an app that can help.
Look for skin cancer apps that allow you to:
Set reminders to check your skin.
Store pictures that you take of your moles, so you can see any change .
These apps can be incredibly helpful because most early skin cancers are found by people who notice a change to their skin. If an app can help you check your skin or jog your memory, it can be a lifesaver.
Apps can help you perform skin self-exams. As for deciding which spots could be skin cancer, that decision is best made by a board-certified dermatologist.
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Causes Of Skin Cancer
Skin cancer is caused by the mutation in the DNA of skin cells. But what is causing that mutation? In most cases, the answer is UV exposure from the sun. Both normal day-to-day exposure when outside, and also from actively trying to tan. But often appears in places that is usually hidden from direct sunlight, so there are other factors in play.
Studies have shown that exposure to toxics can be a cause, for example from the environment that you live in. Also, genetics can be a cause of skin cancer.
The Umskincheck Mobile App Features
- Guidance on performing a skin cancer self exam and full body photographic survey
- Tracking detected skin lesions and moles for changes over time.
- Notifications/reminders to perform self exams on a routine basis
- Storage of photos for baseline comparisons during routine follow-up self exams
- Informational videos and literature on skin cancer prevention, healthy skin as well as a skin cancer risk calculator function
- Version # – 1.2
- Requirements – Requires iOS 4.3 or later. Compatible with iPhone, iPad, and iPod touch. This app is optimized for iPhone 5.
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Dont Skip The Doctor Visit
Skin cancer apps can be useful for tracking moles on your body and even alerting you to new or problematic spots you were unaware of, but they should not be considered as a replacement for a visit to a licensed dermatologist. Patients should continue to see their dermatologist at least once a year for a skin cancer screening, and if you are at all unsure of a mole or lesion you locate with an app, dont delay seeing a doctor in-person for a professional opinion.
Usability Risks Of Smartphone Apps
Smartphone apps pose some risks for the user, specifically, if the algorithm returns a negative result while the user has cancer, and detection and treatment of skin cancer are delayed. It is very challenging to study the rate of false-negatives due to a lack of histological verification. The user may also fail to assess all relevant skin lesions, in particular, if they are located in places that are hard to reach or that the user cannot see. Given that the specificity of SkinVision app is about 80%, there will be a few false-positive cases. This may cause unnecessary stress on users or unnecessary visits to the GP/dermatologist. Finally, the user may not follow the advice given in the smartphone app due to a lack of trust or unawareness.
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Studies Show Apps That Detect Skin Cancer Give Misleading Advice
Using an app may seem like a quick and easy way to find out if a spot on your skin could be cancer. However, studies show that these apps can give you misleading advice.
In looking at the results from nine studies that tested the accuracy of these apps, dermatologists discovered the following:
These apps miss skin cancers.
These apps give different results for the same spot.
None of the apps can find a colorless melanoma, also called amelanotic melanoma.
An app may spot some potential melanomas but be unable to detect other types of skin cancer.
If you rely on a smartphone app to find skin cancer, you risk missing a possible skin cancer, including melanoma. If you have melanoma, it can spread quickly.
To find skin cancer early, dermatologists recommend that you:
Keep all follow-up appointments for skin exams with your dermatologist. To shelter in place, you may be able to meet with your dermatologist via telemedicine.
While apps that examine spots on your skin tend to be unreliable, other skin cancer apps can be helpful.
Check your own skin for signs of skin cancer
Skin self-exams can help you find melanoma early and get treatment, which reduces your risk of the cancer spreading to other areas of your body.
Guidance On Choosing Melanoma Detection Apps
In a study assessing consumer expectations of mobile apps for early melanoma detection, consumers described the following features as important in mobile teledermoscopy apps 3:
- Images: instructions on how to take a good-quality image, example images of what constitutes a suspicious lesion and directions on which image to monitor from a medical practitioner.
- Reminders: participants would like to receive reminders to conduct skin self examinations via push notifications.
- Ease of use: the image-taking and sending process needs to be quick and uncomplicated.
- Set up: apps should integrate single sign-on using their existing information from a social media service, thus removing the step of entering personal details to set up an account.
- Transparency: app transparency was important, and participants would like to see reputable organisations and dermatologists credentials endorsing the service.
In addition, participants reported they would not use apps that took a long time to load, required too many updates or required a large amount of phone memory.NOTE from Health Navigator: Health Navigator believe that it is preferable not to provide health consumers with example pictures of melanoma. This is because melanoma can be very subtle and can have a wide variety of appearances. Consumers could easily be falsely reassured. Read more about melanoma.
In addition, single sign on systems may not be ideal with respect to privacy and security.
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This Was Something On My Own Body That I Hardly Noticed
The SkinIO photos that led Kathy back to her dermatologist, who diagnosed her with melanoma, almost didnt happen.
I was planning to have my husband take my photos. When he got stuck at work I thought about just doing SkinIO another day. My teenage son offered to take the photos on his iPhone. I dont know which of us was more surprised at how easy it was!
Kathys SkinIO results suggested she see a dermatologist for in-person follow up. Her physician diagnosed her with Stage One melanoma.
The spot wasnt huge or particularly concerning. And it was on my back, usually covered up by my bra strap, so it wasnt something I saw everyday. Without SkinIO I never would have gotten it checked when I did.
Kathy had the melanoma removed and is fully recovered. But her experience with the deadliest form of skin cancer prompted her to change her lifestyle – and speak up.
Melanoma is scary because its so silent – you just dont know its there until you have a big problem. I was so lucky that SkinIO got me to my dermatologist when it was still in an early stage. I made my husband go to the dermatologist right away and told all of my friends to go get checked. Its so important.
Data Collection Quality Assessment And Analysis
Two authors independently extracted data by using a prespecified data extraction form and assessed study quality. For diagnostic accuracy, each study would ideally have prospectively recruited a representative sample of patients who used the app on their own smartphone device to evaluate lesions of concern. Verification of results , to determine whether each lesion evaluated was skin cancer or not, would have been conducted byusing histological assessment or follow-up . For verification with expert recommendations, all lesions assessed by the app would be reassessed in person by an expert dermatologist. Data would be reported for all lesions, including those for which the app failed to provide an assessment. These aspects of study quality were assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 tool . Any disagreements were resolved by consensus.
Summary of recommendations for low, moderate, and high risk lesions by named algorithm based apps identified by this review
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Rationale For Using Mobile Health Apps For Early Detection Of Skin Cancer
There are three main types of skin cancersmalignant melanoma , squamous cell carcinoma , and basal cell carcinoma with the latter two also known as keratinocyte carcinoma . In the United States, it was estimated that about 91,000 people will be diagnosed with melanoma and 9300 will die due to MM in 2018 in addition, in 2012, more than 5 million people were diagnosed and 3 million received treatment for KC, which is more than the values for all other cancers combined . Globally, in 2015, there were about 351,000 new incident melanoma cases and 60,000 melanoma-related deaths , with the highest burden of disease in Australasia, North America, and Europe. In the last 30 years, the incidence of MM, adjusted for changes in the age distribution of the population, more than doubled in the United States and the United Kingdom nearly doubled in Norway, Sweden, and New Zealand and increased by approximately 75% in Australia . This is mostly due to changes in risk factors such as increased exposure to ultraviolet light and indoor tanning . Since these risk factors are mostly preventable, comprehensive prevention programs aimed at better sun protection behavior have been implemented in several countries, such as SunSmart in Australia .