An iPhone App for Skin Cancer Diagnosis

A free app is the new coolest thing for DIY skin cancer diagnosis. As long as you're willing to take 23 nude photos of yourself.

UMSkinCheck

If there's one thing that celebrities and politicians have taught us, it's that having naked photos of yourself on your cell phone is never a good idea. Or perhaps -- unless you're doing it to detect skin cancer? Those concerned about modesty might prefer to risk the disease, but a new app for mobile phones out of the University of Michigan allows users to take photos of their skin -- all of it -- as a basis for comparison should suspicious moles or lesions be detected.

Skin cancer lends itself well to DIY diagnosis. It manifests itself visibly and early on, and should, in theory, be easy to detect. But no matter how much time you may spend staring at yourself in the mirror, subtle changes in pre-existent spots or moles that may presage melanoma might not be so obvious. UMSkinCheck establishes a degree of clinical objectivity in the self-exam. Aside from establishing your skin's baseline (see my foray into self-portraiture below), this new, free app includes a risk-assessment survey, periodic reminders to check your body for any signs of cancer, and examples of cancerous lesions so that you know what you're looking for.

UMSkinCheck's developers are pitching the app as a convenient, cost-effective alternative to whole body photography, which traditionally requires a professional photographer. Still, it requires some time and patience to set up, and you can't go it alone. While you're striking 23 different poses, you need a partner to line up your body parts with the outlines on the screen, point, and shoot. Be warned: sexy photo time this is not. Having taken the aforementioned lesson about nude photography to heart, I don't have enough experience with my iPhone's camera to say whether its skin shots typically come out as grainy and downright unattractive as these do, but suffice it to say that you're really going to want to make sure your chosen password is hack-proof.

Vanity should never get in the way of something that is potentially life-saving, but it's a bit hard to imagine that this app will become widely used. Scoring high on the risk-assessment quiz would be, I imagine, one form of encouragement for potential users. Another might be the statistics: the National Cancer Institute estimates that there will be 2 million new diagnoses of basal and squamous cell skin cancer in the United States this year, and 76,250 cases of melanoma, skin cancer's most dangerous form. Giving people the tools to recognize symptoms of such a pervasive disease is a powerful use of technology.

The Institute also warns, however, that "based on fair though unquantified evidence, visual examination of the skin in asymptomatic individuals may lead to unavoidable increases in harmful consequences." Mis- and over-diagnosis are problems associated with over-testing for certain cancers, leading to unnecessary interventions and, at worst, to serious complications. According to Dr. Lynn Schuchter of the University of Pennsylvania and skin cancer editor for cancer.net, early detection of basal and squamous cell skin cancer, conditions that take years to progress and rarely metastasize, is not vital. For melanoma, on the other hand, "early detection makes all the difference in saving lives."

Screening for skin cancer is done via visual examination, and therefore does not involve expensive diagnostic imaging devices (MRI, CT and PET scanners were identified in a May 2012 study as one reason for the United States' disproportionately high healthcare spending), and self-exams save doctors from having to screen patients who are otherwise asymptomatic. But while visible, skin lesions can be extremely difficult to distinguish from numerous other, noncancerous marks and bumps, said Schuchter. If UMSkinCheck can prevent patients from going to the doctor every time an unseemly mole makes them uncomfortable and save further testing for those who are reasonably sure they have something to worry about, then it can contribute to efforts to reform cancer screening.

Seeing as over 90 percent of melanomas are detectable with the naked eye, it makes sense to be aware and to check your body regularly. If you do identify a suspicious mole, a nice component of the app is that it lets you take multiple pictures while you track the lesion over time and then compare them in a side-by-side analysis. If you then decide to consult a physician, you can use the images to demonstrate exactly how the lesion has developed since you first noticed it.

If you decide that you're at-risk enough to be storing revealing photos on your phone, UMSkinCheck is a useful app to have. For what it's worth, the app is password-protected. My own risk assessment tells me that "For every 1,000 women living in this region with these characteristics, on average approximately 0.4 will develop melanoma in the next 5 years." But while I'm going to schedule my self-exam reminders to the longest possible frequency (every 90 days), I'm not going to delete the app too quickly. With melanoma, I'm convinced, you can never be too careful.