Impact of Pigmented Lesion Referral Pathways on Melanoma Detection.

Aim: To assess the effectiveness of pigmented lesion referral pathways, particularly the National Cancer Control Programme (NCCP) pathway, in reducing waiting times and improving melanoma detection rates. Methods: We analysed 2 cohort studies encompassing a prospective 3-month analysis (n=362) and a retrospective 6-month analysis (n=43) of melanoma detection at a tertiary dermatology centre in Ireland. Referral source, reason for referral, waiting times, and histopathological outcomes were evaluated via descriptive analysis. Results: Referrals through the NCCP pathway were associated with shorter waiting times, with 300 (83%) of melanoma patients seen within 12 weeks. Delays in melanoma diagnosis were linked to incidental pickups or incomplete referral information. Outcomes following dermatology review showed that 89 (24.6%) of primary lesions referred required biopsies, however only 11 (3%) were clinically suspicious for melanoma. Histopathological analysis showed a portion of benign lesions or keratinocyte cancers were referred inappropriately through the NCCP pathway. Conclusion: Improving diagnostic confidence in primary care through education, standardized referral criteria, and tele-dermatology tools may help optimize referral quality and reduce waiting times for patients with suspected melanomas.