I have 100% northern European skin plus the grave misfortune of growing up in south Florida, many decades ago.
In other words - thousands of hours of work, sports, and recreational sun exposure.
I have had three basal and one squamous cell skin cancers, plus another four suspicious lesions that I incinerated with pin pricks and blobs of Efudex (anti-metabolite cream).
As far as I am concerned, the USA Dermatology business is an ongoing train wreck for high risk skin cancer patients.
Preemptive cryo-ablation (freezing) is absurdly expensive, and Dermos just stare at your skin until they decide to chop something out and sent it to the Lab.
In a perfect world, Dermos (or RNs or PAs) would single out high risk patients and cryo-ablate everything that even looks suspicious!