Urgent suspicion of cancer referral

  • Lesions on any part of the body which have one or more of the following
    features:
    • Change in colour, size or shape in an existing mole
    • Moles with Asymmetry, Border irregularity, Colour irregularity, Diameter increasing or >6mm
    • New growing nodule with or without pigment
    • Persistent (more than four weeks) ulceration, bleeding or oozing
    • Persistent (more than four weeks) surrounding inflammation or altered sensation
    • New or changing pigmented line in a nail or unexplained lesion in a nail
    • Slow growing, non-healing or keratinising lesions with induration (thickened base)
    • Any melanoma or invasive SCC or a high-risk BCC diagnosed from biopsy
    • Any unexplained skin lesion in an immuno-suppressed patient
    • BCC invading potentially dangerous areas, for example peri-ocular, auditory meatus or any major vessel or nerve.

Good practice points

  • Lesions which are suspicious for melanoma should not be removed in primary care. All excised skin specimens should be sent for pathological examination
  • Lesions suspicious of basal cell carcinomas (BCC) may not require urgent referral, except those invading potentially dangerous areas
  • Referrals should be accompanied by an accurate description of the lesion (including size, pain and tenderness) and photos if possible, subject to clinical governance arrangements, to permit appropriate triage
Full Guideline