When making an urgent suspected cancer (USC) referral (previously known as two-week waits or 2WW), please ensure your patient understands that they have been referred on a suspected cancer pathway and that they should make themselves available for diagnostic tests and outpatient appointments for the next 28 days.

Considerations based on NICE NG-12 guidelines

Only consider a suspected cancer pathway referral for people with a skin lesion that raises the suspicion of a basal cell carcinoma if there is particular concern that a delay may have a significant impact, because of factors such as lesion site or size.

Consider a suspected cancer pathway referral for people with a skin lesion that raises the suspicion of squamous cell carcinoma.

If your index of suspicion is low but you are not totally sure, you can seek Consultant Connect teledermatology advice and guidance. Please ensure that you include the correct images as per the image requirement guidelines. Alternatively, you can consider referring via teledermatology, as concerning lesions will be upgraded to urgent suspected cancer.

Eligibility Criteria

Inclusions

Determine inclusion using the weighted 7‑point checklist from NICE NG-12 guidance.

Major features of the lesions (scoring 2 points each):

• change in size
• irregular shape
• irregular colour

Minor features of the lesions (scoring 1 point each):

• largest diameter 7mm or more
• inflammation
• oozing
• change in sensation 

How to Refer