by Ellen Miller

Angie's List member Cindy George of Oaklandon, Ind., decided to see a specialist after a doctor diagnosed her friend with skin cancer. "I thought about how I'd never had a full skin exam and probably should get that done," she says. A visit with highly rated dermatologist Dr. Keeter Sechrist found no issues.

George considers herself one of the lucky ones. The National Council on Skin Cancer Prevention calls skin cancer "a growing epidemic," saying 1 in 5 Americans will develop some form of the disease.

Sechrist, who has offices in Indianapolis and Carmel, blames the increase on indoor tanning and the aging skin of sun-worshipping baby boomers. "Twenty-seven years ago, in my first year of practice, my senior partner and I saw six melanoma cases," she says. "On one recent week, I saw two. Really disturbing is that skin cancer is now the most common form of cancer in young adults between ages 25 and 29."

Indiana ranks 33rd in the U.S. for melanoma, the most serious type of skin cancer, according to the most recent statistics available from the Centers for Disease Control and Prevention. The Indiana State Department of Health reports 5,474 cases of melanoma in Indiana from 2004 to 2008, with 629 cases in Marion County, 250 in Hamilton County and 65 in Boone County.

Melanoma originates in cells that produce the pigment melanin. Unlike other forms of skin cancer, melanoma can spread and kill if not caught early. Sechrist estimates about 15 percent of her caseload includes patients with melanoma.

Despite high cure rates with early detection, few adults receive the kind of full-body exam George received. The American Academy of Dermatology says only 8 percent of surveyed U.S. workers reported having a skin exam the previous 12 months.

Sechrist says dermatologists don't agree on an official guideline for regular exams, preferring to advise based on individual risk factors, such as family history, number of moles or freckles, and use of tanning beds. Also, many primary care physicians don't conduct skin exams and lack training in detecting skin cancer.

Dr. Lawrence Mark, assistant professor of dermatology at the Indiana University School of Medicine, developed skin-cancer detection guidelines for all IU medical students. "I don't think skin cancer is high on the radar" of most doctors, says Mark, a highly rated dermatologist. "If primary care physicians receive better training, fewer cases will fall through the cracks."

Mark and Sechrist recommend that adults conduct regular self exams. Angie's List member Sandra Miesel of Nora says she checks her skin regularly, especially since Sechrist removed a mole and two other suspicious skin spots in the last 20 years.

"My mother had a spot on her lip that she ignored," Miesel says, and it required surgery. "When they put her face back together, it was twisted. I did not want to end up that way.