Mole mobiles aim to speed up skin cancer screenings as Canada struggles with dermatologist shortage

Bruce Ballingall grew up playing with his five broth‐ ers in the sun. He says they didn't wear hats or sun‐ screen and they all ended up with some form of skin cancer.

"Nobody warned me, until it was too late," said the 75year-old whose skull is cov‐ ered with skin grafted from his legs after the removal of melanomas.

He now volunteers with Melanoma Canada and speaks out to warn others. He says he can't wait for a new mobile cancer screening unit to head to Kamloops, B.C., where his younger brother Brent, 70, has been waiting for almost two years to see a dermatologist.

Skin cancer screening and diagnosis is taking longer in Canada, even as rates of melanoma keep rising due to what experts say is a short‐ age of dermatologists. Skin cancer can spread and be‐ come life threatening within months, but tens of thou‐ sands of Canadians face waits of a year or longer for appointments and treatment, according to Melanoma Canada, a charity and advo‐ cacy group.

Taking to the road

To help ease long wait times to get screened, some are going directly to the pa‐ tients.

Melanoma Canada's mole mobiles launched last spring in Ontario and rolled through 42 communities, screening 4,078 patients and finding 772 suspicious moles or le‐ sions. They've started up again this week in Quebec and B.C., with plans to do 25,000 skin checks this year.

The initiative is funded in part by a non-profit started by Brian "Red" Hamilton, a Vancouver Canucks assistant equipment manager who was warned about a cancer‐ ous mole by a fan sitting be‐ hind him at a Seattle Kraken game in 2022.

Melanoma Canada CEO Fayln Katz told CBC that last year in Ontario, 85 per cent of of patients screened by dermatologists at a mole mo‐ bile followed up with a doc‐ tor within six months. If any‐ thing is found, each patient gets paperwork identifying the type of cancer suspected that they can then take to their doctor.

As of June 1, there were 770 dermatology specialists listed in Canada, according to data compiled by the Canadi‐ an Dermatology Association (CDA). There are also 31 new dermatologists beginning their five year training in 2024, and currently 191 der‐ matology residents and fel‐ lows in Canada.

But their numbers haven't grown much since 2008, when the CDA began warning that a shortage was looming.

The CDA declined inter‐ views this week, but said they were preparing a formal po‐ sition statement on the topic.

LISTEN | Advice for catching and preventing melanoma:

Delays in diagnosis mean skin cancer can spread

That lack of skin special‐ ists can hurt patient out‐ comes, says Philippe Lefrançois, a dermatologist at the Jewish General Hospi‐ tal and skin cancer research‐ er at the Lady Davis Institute in Montreal.

According to the Canadian Cancer Foundation, one in every three cancer diagnoses in the world is skin cancer, most of it caused by ultravio‐ let (UV) radiation. Of the more than 80,000 cases of skin cancer diagnosed in Canada each year, the foun‐ dation says 5,000 are melanoma, the deadliest form of skin cancer.

Experts say melanoma is most common in males over the age of 49 and in young adults. According to Melanoma Canada, unde‐ tected melanoma can spread quickly and kills an average of three Canadians each day.

Lefrançois says it doesn't have to be this way, because melanoma is preventable, and when found early, it can be cured. Too often, he told CBC, the cases his office sees are advanced and require more than a standard treat‐ ment.

"And this is because of, you know, lack of access to dermatologists."

He said the shortage of skin specialists has been ex‐ acerbated by poor pay, lim‐ ited residencies, retirements and the fact that many end up in much higher paying cosmetic practices.

"If I do a skin check, I'm paid less than a surgical on‐ cologist … doing the same thing," Lefrançois said.

In Quebec, he says der‐ matologists doing such checks in their offices are paid just $26. In a hospital setting, he said an oncologist would get $70, while derma‐ tologists working at private medical spa clinics could charge between $250 to $350 for the same service.

WATCH | 'Moles are not something to ignore,' says skin cancer survivor:

Uneven distribution of dermatologists

Eric McMullen, 24, an in‐ coming resident at the Uni‐ versity of Toronto's school of medicine, recently published a study that suggested der‐ matologists are too unevenly distributed across the coun‐ try.

For example, according to the CDA's data, there are 290 licensed dermatologists in Ontario and 96 in B.C., but just 12 in Saskatchewan and one in Prince Edward Island.

"A lot of dermatologists are working in big cities and very, very few are working in rural and remote areas of Canada," he said.

The study noted that cre‐ ating more telehealth op‐ tions or providing dermatolo‐ gists with incentives to prac‐ tice rurally may help.