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Skin Cancer - Recognition and Referral

NICE CKS Skin cancers - recognition and referral. Last revised: Apr 2025. NICE guideline [NG12] Suspected cancer: recognition and referral. Last updated: May 2025.

Guidelines

Suspected cancer pathway referral if there is:

A pigmented skin lesions with ≥3 on weighted 7-point checklist score, or
Dermoscopy suggests melanoma
Nodular melnaoma suspected (consider)

Weighted 7-point checklist:

Major features (2 points each)
- Change in size
- Irregular shape
- Irregular colour
Minor features (1 point each)
- ≥7mm (largest diameter)
- Inflammation
- Oozing
- Change in sensation

Consider a suspected cancer pathway referral if there is a suspected squamous cell carcinoma skin lesion.

Consider routien referral (to dermatology) if there is a suspected basal cell carcinoma skin lesion.

Since basal cell carcinoma is less dangerous, it only warrants routine referral, while malignant melanoma and squamous cell carcinoma warrant suspected cancer pathway referral.

References

NICE CKS Skin cancers - recognition and referral
NICE guideline Suspected cancer: recognition and referral

Author: Adams Lau
Reviewer:
Last edited: 15/07/25

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