This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

NICE urgent referral guidance for suspected malignant melanoma

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Skin cancers

Malignant melanoma of the skin

  • refer people using a suspected cancer pathway referral (for an appointment within 2 weeks) for melanoma if they have a suspicious pigmented skin lesion with a weighted 7-point checklist score of 3 or more.

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 7 mm or more
  • inflammation
  • oozing
  • change in sensation.

Refer people using a suspected cancer pathway referral (for an appointment within 2 weeks) if dermoscopy suggests melanoma of the skin

Consider a suspected cancer pathway referral (for an appointment within 2 weeks) for melanoma in people with a pigmented or non-pigmented skin lesion that suggests nodular melanoma

Squamous cell carcinoma

  • consider a suspected cancer pathway referral (for an appointment within 2 weeks) for people with a skin lesion that raises the suspicion of squamous cell carcinoma

Basal cell carcinoma

  • consider routine referral for people if they have a skin lesion that raises the suspicion of a basal cell carcinoma
  • NICE have now suggested that a possible basal cell carcinoma may warrant a two week referral but
    • "..only consider a suspected cancer pathway referral (for an appointment within 2 weeks) 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. .."

Notes:

  • in a previous version of the guidance there was a description of what was a suspected squamous cell carcinoma (2):
    • with non-healing keratinizing or crusted tumours larger than 1 cm with significant induration on palpation. They are commonly found on the face, scalp or back of the hand with a documented expansion over 8 weeks
    • who have had an organ transplant and develop new or growing cutaneous lesions as squamous cell carcinoma is common with immunosuppression but may be atypical and aggressive
    • with histological diagnosis of a squamous cell carcinoma

Reference:


Related pages

Create an account to add page annotations

Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.