Anecdotally, when I had a potential skin cancer checked at a London hospital they were completely ill-prepared. When I came back to Australia, it was checked and immediately removed as an obvious melanoma. Perhaps the idea of Comparative Advantage also applies to healthcare between countries with natural variances to types of disease?
My experience - Having had at least 10 skin cancers cut out over the last 30 ish years, is the only way that it can definitely be determined ( skin cancer or not ) is a biopsy.