Considerations based on NG-12 guidelines

For suspected basal cell carcinoma

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.

For squamous cell carcinoma

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 (A&G), and your query will be reviewed with a response received within 24 hours. Please ensure that you include the correct images as per the image requirement guidelines. Alternatively, you can consider referring via teledermatology, as response times are now much improved and concerning lesions will be upgraded to urgent suspected cancer.

Guidance for referring patients for suspected skin cancer

• Local trusts are offering patients, referred via the urgent suspected skin cancer pathway, a teledermatology appointment, allowing for a remote dermatology review more quickly. Patients who may be suitable are identified post referral. To aid trusts in selecting the appropriate patients, please ensure the referral includes:
  • clearly indicated location and number of lesions
  • risk factors or history of skin cancer
  • performance status.
• If a GP feels that a patient may be suitable for teledermatology they can include this within the narrative of the urgent suspected cancer forms and it will be picked up in triage.
• Patients need to be available for appointments in the next two weeks to give time for trusts to be able to complete the diagnostics in time to reach the faster diagnosis standard (28 days).

Eligibility Criteria

Inclusions

• resident of NCL

• weighted 7‑point checklist

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