Melanomas excised in primary care vs secondary care excision
Research type
Research Study
Full title
Do melanomas excised in primary care have different outcomes to those excised in secondary care?
IRAS ID
183757
Contact name
Peter Murchie
Contact email
Sponsor organisation
University of Aberdeen
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Melanoma is a dangerous skin cancer, increasingly common due to increased foreign holidays and sun-bed use. Melanoma usually begins as a new or changing mole. Diagnosed quickly it can be removed in a simple operation and effectively cured. GPs can do this operation and many are highly skilled in minor surgery. However, guidelines written by specialists insist that all patients who might have a melanoma should be referred to hospital.
People are becoming more skin aware and GPs are checking moles much more often. Sensibly many of these patients are being sent to hospital for a check, although most will not have melanoma.
As a result hospital skin clinics are very busy and waiting times are increasing.
People who do have a melanoma that is not clinically obvious are waiting an increasingly long time to have it diagnosed and treated in hospital, and this could actually mean that melanoma has more chance to spread while they wait.
We conducted studies on 1200 people with a melanoma in Northeast Scotland between 1991 and 2008 finding that 20% of these people had their melanoma diagnosed and treated by their GP. These patients were no more likely to receive improper treatment than those referred to hospital. People who had their melanoma removed by a GP were no more likely to die from melanoma, and required fewer hospital visits afterward suggesting that the guidelines could be changed to allow GPs to treat suspicious moles. This would be better for patients and the NHS.
However, we cannot recommend changes to the guidelines on the basis of local research therefore we wish to extend our study using data from 18,000 patients with melanoma from across Scotland. The results of this study will inform how the health service should deal with suspicious moles in the future.REC name
London - Surrey Research Ethics Committee
REC reference
15/LO/1385
Date of REC Opinion
4 Aug 2015
REC opinion
Favourable Opinion