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High-risk individuals have characteristics that justify regular skin checks due to:
More than 95% of melanomas relate to sun exposure, specifically exposure to ultraviolet radiation. The relationship is complex. For these melanomas, risk factors are well established.Risk profiling specifically identifies:
Rare types of melanoma are equal in incidence in all races and skin types, for example, acrolentiginous, melanoma, mucosal melanoma, melanoma in childhood, noncutaneous melanoma (e.g. ocular) etc.
The risk for an individual is uncertain. There are various online tools to determine this but most are based on non-New Zealand data.
The New Zealand melanoma risk predictor tool developed by Dr Mary-Jane Sneyd is available to New Zealand GPs through BPAC.
Risk factors for basal cell carcinoma (BCC) are similar to melanoma, except a lack of association with number of melanocytic naevi. Family history of BCC is possibly more important than for melanoma. Data is lacking.
Actinic keratosis and squamous cell carcinoma (SCC) are primarily caused by cumulative sun damage rather than being associated with intermittent sunburn. Outdoor work and recreation and white skin that burns easily in the sun are relatively more important compared to melanoma and basal cell carcinoma.
There are some syndromes that increase risk of SCC / BCC.
Immunosuppressive drugs markedly increase the risk of all skin cancers, but especially actinic keratoses and squamous cell carcinomas. Organ transplant recipients should be under regular surveillance.
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