The skin cancer apps that can check your suspicious-looking moles

by Ruth Nichol / 14 June, 2018

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Smartphone apps are a popular new tool in the battle against skin cancer, but some experts are concerned.

Do you have a mole you think has changed size, shape or colour but you’re putting off going to the doctor about it? Join the club. International studies have found that people wait from three months to more than a year before getting a suspicious skin lesion checked.

No similar studies have been done in New Zealand, but an online survey carried out in 2016 for several organisations involved with skin cancer detection found that less than half of the 500 Kiwis surveyed said they would seek medical advice if they noticed a suspicious-looking mole. Instead, they’d consult Google, adopt a “wait and see” approach or simply ignore it.

“Behavioural insight studies show that there are both real and perceived barriers to people going to see their GP,” says Hayden Laird, whose company, Firstcheck, was involved in the survey. “It’s more straightforward if you’re sick in bed, but skin cancer isn’t like that. It requires early detection and a proactive approach.”

Firstcheck provides the first New Zealand-developed smartphone app to help detect skin cancer, particularly its most serious form, melanoma. People can use the app to take a photograph of a mole and send it to a local skin specialist for a risk assessment. Each consultation costs $19.95 and the results are available within 72 hours. The company also sells a $29.95 smartphone lens attachment to magnify the image – a version of the dermoscopes doctors use to help diagnose skin cancer.

New Zealand has the world’s highest rate of melanoma. More than 4000 new cases are diagnosed and more than 300 people die from it every year. Early detection is vital to reduce melanoma deaths, and most experts agree this is best done by regular skin self-examination to look for moles that have changed appearance. A study by the University of Otago of melanoma patients diagnosed from 2012-2014 found that 64% of melanomas are found this way, and another 16% were first noticed by a family member.

Monika Janda.

Given the general reluctance to seek medical advice about suspicious moles, it’s not surprising that smartphone apps to detect skin cancer are a growth industry. They’re cheap, relatively easy to use and they don’t require a doctor’s appointment.

According to Queensland University behavioural scientist Monika Janda, more than 43 apps have appeared since 2014. Some are purely informational – they send reminders to check your skin and provide guidance about what to look for. Others, like Firstcheck, involve taking photos and sending them to an expert – what’s known as teledermatology.

Of more concern to Janda and others working in this area are automated smartphone apps. Rather than sending a photograph to a doctor, they use algorithms to analyse the photo and provide an immediate risk classification. Janda co-authored a study, published in the Australasian Journal of Dermatology in 2017, that compared the decisions made by three automated apps with those made by two consultant dermatologists. Of the 42 lesions classified as suspicious by the dermatologists, only nine to 26 were classified as suspicious by the apps.

Although apps in general show a lot of promise, Janda says they need more rigorous testing to ensure they don’t do more harm than good by providing false reassurance about moles that may be malignant. “I think they’re here to stay, but for apps that are part of the medical pathway, it’s important to prove they’re doing what they’re intended to do.”

Paul Jarrett, president of the New Zealand Dermatological Society, is cautiously optimistic about the apps, particularly if they encourage people to inspect their skin more regularly. But he agrees they need more testing. “One of the problems is validating them. Do they make a difference?”

He’s involved with a University of Auckland research project that may lead to a completely different – and ultimately more accurate – way of diagnosing skin cancer by using a hand-held laser device. Rather than making a diagnosis based on a mole’s appearance, the device will use light to identify information not available through visual examination.

The research is funded by a $1 million Government grant and led by scientist Cather Simpson, who says that the device, though initially aimed at doctors, may become publicly available. “I would like to see it for sale in electronics stores and pharmacies.”

This article was first published in the June 2, 2018 issue of the New Zealand Listener.

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