Understanding skin cancer tests, screening and diagnosis

Unlike some other types of cancer, there is currently no national skin cancer screening programme in the UK. Early detection relies on personal vigilance, regularly checking your skin, including areas exposed to the sun, for abnormal skin lesions, discoloured moles or patches, and reporting suspicious moles or changes to your GP. Those at increased risk, such as people with a family history of skin cancer, lighter skin, red or blond hair, light coloured eyes, or weakened immune systems, may benefit from scheduled skin checks or monitoring in a dermatology clinic.

Screening for skin cancer is about spotting potential cancerous cells, whether squamous cell skin cancer, basal cell skin cancer (BCC), or melanoma skin cancer, at an early stage, so they can be treated early.

Benefits and risks of skin cancer assessments

Regular self-checks and prompt clinical assessment is the opportunity to catch non-melanoma skin cancer or melanoma skin cancer at the earliest, most treatable stages. Nearly all skin cancers can be treated most effectively when caught early.

Initial assessment: When you notice a change

Skin self-awareness involves understanding how your skin, moles, and spots usually look, making it easier to notice when something about your skin cells changes. Many abnormal cells on sun-exposed skin are harmless, but some can develop into skin cancers if left unchecked.

Skin self-awareness involves understanding how your skin, moles, and spots usually look, making it easier to notice when something about your skin cells changes. Many abnormal cells on sun-exposed skin are harmless, but some can develop into skin cancers if left unchecked.

When you see your GP or visit a dermatology clinic about a suspicious mole or lesion, the skin cancer diagnosis process usually begins with:

• Reviewing your medical history and risk factors
• Visual and dermatoscopic examination of the suspicious area
• Assessing nearby lymph nodes for any physical changes

Some clinics use imaging tests such as mole mapping, especially for people at increased risk of developing melanoma.

Skin biopsy: Confirming the diagnosis

The gold standard test for confirming most skin cancers is the skin biopsy. Depending on the location and appearance of your skin lesion, your doctor may recommend:

• Excisional biopsy: Removing the whole suspicious area
• Incisional or punch biopsy: Removing a deep tissue sample
• Shave biopsy: Removing a superficial sliver, useful for flatter lesions.

These procedures are generally performed with a surgical knife or punch under local anaesthetic, and recovery is usually quick. 

Advanced diagnostic tests

If a skin cancer test shows high-risk features, such as in melanoma or squamous cell cancers, further skin cancer tests may be done:

• Sentinel lymph node biopsy: Used particularly in melanoma skin cancer to check if cancer cells have moved to nearby lymph nodes (sentinel nodes).
• Lymph node biopsy: Sampling nodes that seem abnormal for cancerous cells.
• Imaging tests: CT, MRI scans, or PET scans may be used to look for spread to other organs or deeper tissues.
• Blood tests: Help assess general health, organ function, and may be relevant for rare types or advanced cancer.

Some rare types of skin cancer, like Merkel cell carcinoma, may require extra screening tests or referral to speciality centres.

Most skin biopsy results are available within two weeks. Imaging or other further tests for staging are usually reported promptly, especially for suspected melanoma or squamous cell carcinoma SCC. Your clinician will explain whether cancer was found, the characteristics of the cancer cells (including depth and whether abnormal cells have spread), and whether skin cancer treatment, monitoring, or additional tests are needed.

Supporting your skin health journey

Preparing for Appointments

• List any symptoms of skin cancer, treatments or screening tests you’ve had
• Note medications, allergies, family or medical history, or if you’ve been exposed to the sun, tanning beds or have a weakened immune system
• Bring a friend if needed and keep your paperwork organised

Managing anxiety and stress

Don’t hesitate to reach out for further specialist support and consider support groups if needed.

You are not alone. With compassionate care, knowledgeable teams, and a focus on early detection and comprehensive treatment, you can face each step with clarity and confidence.

Moving forward with confidence

Early detection gives you the best chance of success, no matter the type (including non-melanoma skin cancer, basal cell cancers, or melanoma). Remember, most skin cancers can be effectively treated when caught early.

Your healthcare team is here to guide you, answer your questions, and support you with the latest advances in screening for skin cancer, early detection, and skin cancer treatment options.

Your guide to skin cancer treatment