PA13 Paediatric 2-week-wait skin cancer audit

Published Date: 23rd December 2019

Publication Authors: Hanley T

Abstract

The incidence of skin cancers is rising, and dedicated 2-week wait skin cancer clinics have been set up throughout the U.K. However, skin cancer in paediatric patients is relatively rare, with a reported incidence in the U.S.A. of 1.1 per million in 1 4 year olds, and 10.4 per million in 1519 year olds (Saiyed FK, Hamilton EC, Austin MT. Pediatric melanoma: incidence, treatment and prognosis. Pediatric Health Med Ther 2017; 8: 39 45). In 2015, the National Institute for Health and Care Excellence provided updated guidelines on skin cancer recognition and referral'. While the incidence of skin cancer is higher in the adult population, these guidelines cover all age groups, and provide advice on when the primary care physician should refer a suspected skin cancer, advice on the 2-week time frame when patients should be reviewed in secondary care, and advice on the 62-day target for first treatment. We conducted a retrospective audit of all patients who were referred under the 2-week wait skin cancer pathway over a 1-year period. In our institution, patients are reviewed in either a dermatology or plastic surgery clinic. The primary aim of our study was to determine whether patients were reviewed within the recommended 2-week time frame, and whether the 62-day treatment target was achieved. The secondary aims were to determine how many patients were being referred under the 2-week wait pathway over a 1-year period, to determine whether any skin cancers were suspected in secondary care, and to determine whether any skin cancers were diagnosed on histopathology review. Electronic case records were analysed from August 2017 to August 2018 and a pro forma was completed. In total, 81 patients were referred from primary care for evaluation of a suspected skin cancer, with 53% female, 47% male and a mean age of 11 years (range 117). Overall, 99% of patients were reviewed within 2 weeks of referral, and 100% of patients had first treatment completed within the 62-day target. Two patients from dermatology and five patients from plastic surgery underwent urgent excision of a skin lesion where a skin malignancy could not be completely refuted. No patients were diagnosed with a skin cancer after histopathology review. In conclusion, 81 patients were referred over a 1-year period as potentially having skin cancer. Patients of different ages were reviewed and no skin cancers were detected.

Hanley, T; Lavery, M; Thompson, B; Fattah, A; Parslew, R; Al-Sharqi, A. (2019). PA13 Paediatric 2-week-wait skin cancer audit . British Journal of Dermatology. 181 (S1), 150

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