Table 1.
Summary of recommended screening practices that may be considered for specific high-risk populations
| High-risk population subsets | Additional screening practices to consider based on published guidelines |
|---|---|
| All “high-risk” patients | Offer a surveillance program (as least annually) |
| Referral to specialist | |
| Dermoscopy by trained professional | |
| Total-body photography | |
| Advanced age, male sex, fair skin/hair, inability to tan, prior significant UV exposure | No additional recommendations |
| Patient anxiety or Inability to recognize disease | Frequent clinical exams |
| Personal history of melanoma | Frequent, lifetime clinical exams |
| Referral to specialist | |
| Family history (some specify ≥3 family members or melanomas) | Frequent, lifetime clinical exams (every 3–12 months) |
| Confirm age at diagnosis and tumor pathology | |
| Frequent clinical exams (start at age 12 for first-degree relatives, age 20 for second-degree relatives) | |
| Referral to specialist | |
| Genetic testing | |
| Multiple nevi | Frequent, lifetime clinical exams (every 6–12 months) |
| Referral to specialist | |
| Dermoscopy by trained professional | |
| Total-body photography | |
| Sequential digital imaging over time | |
| Biopsy any changed lesions | |
| Not recommended: prophylactic removal of small/medium congenital or nonsuspicious lesions | |
| Large congenital nevi (>15–20 cm) | Frequent, lifetime surveillance (every 6–12 months) |
| Referral to specialist | |
| Total-body photography | |
| Sequential digital imaging over time | |
| Biopsy any changed nevi | |
| Consider prophylactic removal of nevus | |
| Newborns: MRI within the first 6 months of life | |
| Dysplastic nevi | Comprehensive personal and family history |
| Frequent, lifetime clinical exams (every 3–12 months) | |
| Referral to specialist | |
| Dermoscopy by trained professional | |
| Total-body photography | |
| Sequential digital imaging over time | |
| Biopsy any changed lesions | |
| Not recommended: prophylactic removal of nevi | |
| Genetic mutations (MC1R, TYR, TYRP1, SLC45A2, ASIP/PIGU/MYH7B) | Frequent clinical exams |
| Referral to specialist | |
| Dermoscopy by trained professional | |
| Total-body photography | |
| Sequential digital imaging over time | |
| Familial atypical multiple mole melanoma syndrome (CDKN2A/MTAP) | Dermoscopy every 3 months by trained professional |
| Research only: referral to gastrointestinal specialist at age 45 or if family history of pancreatic cancer | |
| Transplant recipients or those chronically immunosuppressed | Referral to specialist |
Abbreviations: UV, ultraviolet; MRI, magnetic resonance imaging.