Health care apps – Skin cancer detection

skin cancer detectionThe Doctor Mole skin cancer detection app

I was browsing through some smartphone apps last week and I ran across one called Doctor Mole. At first I thought it had something to do with the garden pest—I have an infestation of moles plowing through my vegetable garden every evening, so they are much on my mind.

I thought, “Yes! An app to tell me how to get rid of moles!”

Nope. Wrong kind of mole.

But I was still interested. I had heard of these skin cancer tracking apps, so I decided to take a look and see what was available and how they work. My husband has had a basal cell cancer removed from his face and is always on the lookout for more. Would this app help him?

Doctor Mole is available in a free version and a paid version ($4.99). It was developed in Australia, where they take skin cancer prevention and detection very seriously.

The free version of Doctor Mole provides plenty of useful information about assessing moles for cancer—the routine ABCDEs:

  • Asymmetry (do the two halves of the mole match or not?)
  • Border (are the borders even or irregular?)
  • Color (is the mole one color, two or more?)
  • Diameter (is it larger than 1/4 inch—about the diameter of a pencil eraser?)
  • Evolving (has it gotten bigger over time or changed in another way?)

The app helps you take a clear picture (lighting, distance) of your mole. You can store the photos and then be reminded every few weeks or months to re-check the mole.

If you want the picture analyzed for risk, you must have the paid version. The app uses an algorithm based on the ABCDEs to determine if the mole is at a high risk of being cancer and, if so, instructs you to contact a dermatologist.

The Skin Vision skin cancer detection app

Another app, Skin Vision, also comes in free and paid ($4.99) versions.skin vision app

The free version (you must still be a registered user) mostly provides information about skin health and cancer prevention. It also has a UV index feature so you can track UV exposure.

Personally, I like the EPA’s free UV index app.

You need the paid version to upload pictures for analysis. Again, it’s a mathematical algorithm that determines whether a particular mole should be seen by a dermatologist. (This app also allows you to search for a dermatologist!)

All these apps also include an obligatory disclaimer that they are “not substitutes for professional medical advice, should never replace professional advice, and never delay a patient seeking medical treatment/advice.”

Hmm, sounds like they are saying to seek medical treatment, regardless, doesn’t it?

Which begs the question—

Are apps for skin cancer detection worthwhile?

In my opinion? Meh, not very.

If you know the ABCDEs of moles and are observant you can probably determine for yourself if a mole should be checked out by a physician. If you have a camera, you can take your own pictures and use them for comparison. Take measurements of the mole, or place a ruler next to the mole when you take the picture, so you have an idea of its size and can more easily tell if it has changed.

Last year, the Journal of American Medicine (JAMA) published a study looking at the accuracy (or inaccuracy) of these skin cancer smartphone apps. They did not name the apps, but 3 out of 4 apps had an accuracy rate of only about 70%. That’s about the same as your average primary care physician. These three apps used the algorithm-based analysis.

A dermatologist with a fancy dermascope has about a 90% accuracy rate.

The fourth unnamed app had a better accuracy rate because it had board-certified dermatologists reviewing the pictures.

I did find an app called SpotCheck that uses board-certified dermatologists (at $4.99 per analysis) but as far as I can tell that app is no longer available or supported. Perhaps not enough dermatologists wanted to participate—after all, wouldn’t such an app reduce their patient referrals?

Bottom line: I’m not going to use one of these apps. If you just want pictures and information, these apps are fine, but I would not trust the analyses.

Most skin cancers, such as basal cell and squamous cell, are pretty slow growing and it’s OK to watch them a bit and see if they change over time.

Melanomas are not as forgiving. If you have a skin lesion that is at all suspicious of melanoma, see your physician.

Sláinte!

Frugal Nurse

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