Skin Cancer Apps and Cancer Detection in 2020
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Smartphone apps, downloaded for iPhone and Android, which are designed to assist people worried about skin cancer, popularly known as “skin cancer apps”, have been on the rise in recent years.
As smartphone cameras have improved, and become widespread, some companies have released skin cancer scanning apps into the app stores to automatically diagnose skin cancer. 1
But is skin cancer something that can be safely and automatically diagnosed through smartphone apps? Unfortunately, not.
In recent years there has been exciting research into how imagery can be used for managing the risks of skin cancer and assessing individual lesions for melanoma.
Some Artificial Intelligence research has shown promising results for melanoma risk assessments on lesions from magnified photos taken in clinical contexts – also called digital dermoscopy, where a machine learning algorithm has achieved results on par with dermatologists.2
It is to be expected that such algorithms at some point will make their way into the healthcare system. There are, however, many challenges that need to be solved besides the technical challenge of developing the algorithm itself. The behavioral, legal and regulatory challenges are very complex and need to also be addressed. Hence, we expect that algorithms will first gain wide-spread adoption as clinical support systems for specialists before they are integrated into apps for consumers to download. To our knowledge, the Federal Drug Administration in the United States (FDA) have so far not approved any apps that offer an algorithmic assessment.3
For now, apps with an explicit skin cancer detection element should be treated with caution.4
Read on to further learn why Miiskin are not currently trying to develop a skin cancer diagnosis or a skin cancer scanning app and why going to the doctor is still recommended if you are worried about something on your skin.
We will later also address how we think smartphone apps can help in a consumer context today.
“Skin Cancer Apps / Melanoma Apps” and Diagnoses
Melanoma is an uncontrolled growth in certain cells of the skin. People, therefore, understand that they need to look out for any changes in the skin’s appearance that could result from this abnormal growth. Melanomas have certain characteristic features that people can watch out for and it’s useful to increase awareness of these to help improve the effectiveness of regular skin self-examinations.
These characteristic features have been communicated by healthcare professionals through important messages about the ABCDE criteria of melanoma and the Ugly Duckling rule.
It’s important to remember that these early signs only look for potential problems and does not suggest that skin cancer can be diagnosed with the naked eye or with a single smartphone image. A recent research review publication shows that this is not yet the case.5
Please read Miiskin’s guide to the signs of skin cancer which provides more information on ways to potentially discover early signs.
Potential Skin Cancer Detection via Telemedicine Apps
In recent years, novel services through which people send smartphone photos to a local dermatologist or specialist have shown positive results as a way to bring the possibility of skin cancer to consumers’ attention and to promote early presentation to a doctor. Such services are now available in some markets where skin cancer is most prevalent. Even though they often involve a dermatologist, they communicate that the service is not an explicit diagnostic tool for skin cancer, but as a way to sound an early alarm about a suspicious skin lesion. Such services will, therefore, recommend that consumers seek out additional medical advice about their skin concern.6
Miiskin is currently not offering such a store-and-forward service and Miiskin’s users are encouraged to see their doctor if they wish to have a lesion medically examined.
Together with collaborating dermatological experts, we are following the development closely – this area can and should develop, albeit in a prudent manner. New technology has great potential in reducing healthcare costs, improving patient outcomes and improving quality of life for all of us – including in the dermatological space.
For the time being, a physician should also be able to ask you additional questions, touch and closely examine the mole or mark in order to have the best chance of making a correct diagnosis. Specially trained doctors may also use a dermatoscope to examine a lesion and if they are concerned a biopsy will often be required.
For now the best “skin cancer app” may be that which does not try to automatically diagnose skin cancer or provide a risk score.
The next section addresses how smartphone apps can currently help with your own skin examinations.
How a Smartphone Health App Can Help with Skin Checks
Over 50% of moles or marks that turn out to be cancerous are initially identified by the patient themselves.7 As a result many organisations recommend the general population and in particular those at increased risk of skin cancer to perform regular skin self-examinations to detect skin changes.
In the last few years renowned doctors and organisations have also started recommending consumers to use photography as an aid to skin self-examinations.8
There are two main ways you can use photos to keep track of changes to your skin. You can either photograph individual moles and marks you want to keep a closer eye on or you can photograph wider areas of your skin – The latter could help you identify new moles or marks on your skin.
The Miiskin app helps you photograph individual moles and also capture wider photos of four large areas of your skin (the front torso and back torso – including the arms, and the front of legs and back of legs) – A sort of light-weight Total-Body Photography.
Miiskin’s Skin Mapping is a new exciting feature we are developing, which automatically identifies and highlights all the moles and marks on the skin that the computer can identify. This helps you identify the moles and marks on your wide-area photos – making it easier for you to be on the lookout for new moles or marks over time.
But remember the Miiskin app does not diagnose skin cancer. It assists you to look out for skin changes and become more aware of your skin. It is your doctor’s responsibility to medically assess any changes on your skin.
Read more about the Miiskin app
Are you a healthcare professional? You may also want to read the article on apps and skin self-examination, created for DermNet NZ.
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References:
1 https://www.ncbi.nlm.nih.gov/pubmed/25600815
2 https://www.nature.com/articles/nature21056
3 https://www.fda.gov/MedicalDevices/DigitalHealth/ucm575766.htm
4 https://onlinelibrary.wiley.com/doi/abs/10.1111/ajd.12758
5 https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013192/full
6 https://www.ncbi.nlm.nih.gov/pubmed/27926766
7 https://www.jaad.org/article/S0190-9622(16)30486-8/pdf
8 British Skin Foundation, CANSA, Melanoma Institute Australia, Danish Dermatological Society, Queensland Department of Health, WebMD and UpToDate.
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