Melanoma is the most serious form of skin cancer, causing 79 percent of all skin cancer deaths. More than 53,000 new melanomas will be diagnosed this year.

Fortunately, these cancers are usually curable if detected early: Patients diagnosed in the earliest stage of melanoma have a 90-plus percent survival rate at five years, while those diagnosed at the most advanced stage have a 20 to 30 percent survival rate.

Early detection is not always easy: Of all the moles in the United States, only one in 20,000 to 200,000 is a melanoma, so searching for an early-stage melanoma is a lot like looking for a needle in a haystack. The commonly recommended "ABCD" detection technique--looking for moles that are Asymmetrical, have an irregular Border, have uneven Color, or a Diameter larger than a pencil eraser--is quite helpful in detecting advanced melanomas, but to catch these cancers earlier, it's important to take additional steps.

• First, understand your risk profile. About half of melanomas occur in just 1 to 5 percent of the population. This high-risk group includes people who have:
  • A personal or family history of melanoma (two or more close relatives who have been diagnosed with melanoma)
  • Dysplastic (atypical) moles
  • Numerous moles (generally more than 50)
  If you have one or more of these traits, regular skin checks may help save your life.
• Look beyond your moles. Many people are told that they have "precancerous" moles, but this term is a poor term: dysplastic (or atypical) moles are better considered a risk marker for melanoma. At least half of melanomas appear in normal skin.
• Look for moles that don't match. Every person makes moles differently, so it's hard to come up with a blanket description of normal moles versus early melanomas. If you see a new mole that looks different than your other (average) moles--a different color, irregular shape, a more pronounced border--that is a warning sign.
• Look for changes in your moles. Identifying changing moles is one of the keys to early detection. All moles are new at some point, so a new or enlarged mole is not necessarily a melanoma. However, if you note a changing mole it is appropriate to seek medical advice.
• If you have had a previous melanoma, dysplastic moles, or numerous moles, ask your doctor about total-body photography. Instead of relying on memory to determine whether a mole has changed, many dermatologists now offer total-body photography to provide a baseline for comparison at future examinations. At Duke, and a growing number of clinics nationwide, MoleMapCDs are being used. These CDs can be used in the clinic and at home to allow for comparisons.
• If you have a suspicious mole, ask your doctor about dermoscopy. Sometimes called "epiluminescence," this procedure involves examining the skin with a hand-held microscope. While not foolproof, it can help doctors look more closely at moles to identify abnormalities.
• Heed your own concerns. If you are concerned about an area on your skin, that is enough reason for your doctor to be concerned as well. Don't hesitate to ask for a second opinion if needed.