Diagnosis of non-melanoma skin cancer

Diagnosing non-melanoma skin cancer usually begins with a visit to your family doctor. Your doctor will ask you about any signs or symptoms you have and will do a skin exam. Based on this information, your doctor may refer you to a specialist, such as a dermatologist or surgeon.

The process of diagnosis may seem long and frustrating. It’s normal to worry, but try to remember that other health conditions can cause similar signs and symptoms as non-melanoma skin cancer. It’s important for the healthcare team to rule out other reasons for a health problem before making a diagnosis of non-melanoma skin cancer.

A health history, skin exam and skin biopsy are commonly used to rule out or diagnose non-melanoma skin cancer.

Health history and skin exam

Your health history is a record of your symptoms, risk factors and all the medical events and problems you have had in the past. In taking a health history, your doctor will ask questions about your history of:

  • sun exposure and indoor tanning
  • signs or symptoms that suggest non-melanoma skin cancer
  • actinic keratosis, which is a precancerous condition of the skin
  • inherited conditions, such as xeroderma pigmentosum and basal cell nevus syndrome

Your doctor may also ask about a family history of skin cancer, both non-melanoma and melanoma.

A skin exam allows your doctor to look for any signs of skin cancer or an abnormal area of skin. During a skin exam, your doctor will check the entire surface of your skin, especially areas of skin exposed to the sun.

Find out more about skin exam.

Skin biopsy

During a skin biopsy, the doctor removes tissue or cells from the skin for testing in a lab. The report from the pathologist (a doctor who specializes in the causes and nature of disease) will confirm whether or not cancer cells are present in the sample. The type of biopsy used often depends on what the growth or abnormal area looks like and where it is located.

Shave biopsy shaves off a growth or abnormal area of skin using a flexible razor blade or a surgical knife (scalpel). It is usually used for raised growths. It can also be used for flat abnormal areas that are only on the outer surface of the skin (superficial).

Punch biopsy removes a round area of skin using a sharp tool called a punch or trephine. It is usually used when the growth or abnormal area is under the skin or seems to have grown deep into the skin.

Excisional biopsy (a type of surgical biopsy) removes the entire growth or abnormal area using a scalpel. It is usually done when the doctor thinks the whole growth or area needs to be examined to make a proper diagnosis.

Find out more about shave biopsy, punch biopsy and excisional biopsy (surgical biopsy).

Questions to ask your healthcare team

To make the decisions that are right for you, ask your healthcare team questions about diagnosis.

Expert review and references

  • American Cancer Society . Skin Cancer: Basal and Squamous Cell . 2015 : https://www.cancer.org/.
  • Cancer Research UK . Diagnosing skin cancer . 2014 : https://www.cancerresearchuk.org/.
  • Christensen SR, Leffell DJ . Cancer of the skin. DeVita VT Jr, Lawrence TS, Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 92:1314-1336.
  • National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Basal Cell Skin Cancer (Version 1.2015). 2015.
  • National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Squamous Cell Skin Cancer (Version 1.2015). 2015.
  • Sapijaszko M, Zloty D, Bourcier M, Poulin Y, Janiszewski P, Ashkenas J . Non-melanoma skin cancer in Canada chapter 5: management of squamous cell carcinoma. Journal of Cutaneous Medicine and Surgery. 2015.
  • US National Library of Medicine. MedlinePlus Medical Encyclopedia: Skin Lesion Biopsy. 2015: https://www.nlm.nih.gov/medlineplus/ency/article/003840.htm.
  • Zloty D, Guenther LC, Sapijaszko M et al . Non-melanoma skin cancer in Canada chapter 4: management of basal cell carcinoma. Journal of Cutaneous Medicine and Surgery. 2015.

Medical disclaimer

The information that the Canadian Cancer Society provides does not replace your relationship with your doctor. The information is for your general use, so be sure to talk to a qualified healthcare professional before making medical decisions or if you have questions about your health.

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