Basal cell carcinoma: are early appointments justifiable?

• Published in: British journal of dermatology (1951) Vol. 142; no. 3; pp. 446 - 448
• Main Authors: Gordon, P.M., Cox, N.H., Paterson, W.D., Lawrence, C.M.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.03.2000; Blackwell; Oxford University Press
• Subjects: Adult; Aged; Aged, 80 and over; basal cell carcinoma; Biological and medical sciences; Carcinoma, Basal Cell - pathology; Dermatology; Dermatology - organization & administration; Disease Progression; Female; hospital referral; Humans; Male; Medical sciences; Middle Aged; Referral and Consultation - organization & administration; Retrospective Studies; Skin Neoplasms - pathology; Time Factors; Tumors of the skin and soft tissue. Premalignant lesions; Waiting Lists; United Kingdom; Europe; Human; Skin disease; Basal cell carcinoma; Clinical management; Malignant tumor; Emergency; Statistical study
• ISSN: 0007-0963; 1365-2133
• DOI: 10.1046/j.1365-2133.2000.03354.x

In the U.K., patients with suspected skin tumours are usually referred from a general practitioner to a hospital‐based dermatologist for treatment. The urgency of such referrals is currently a topic of political importance. We have studied case record data from 162 patients with basal cell carcinoma (BCC) to establish the relevance of referrals routinely being considered urgent. At presentation, mean tumour size (maximum dimension) was 7·4 mm (median 10) and mean duration of BCC was 20·5 months (median 12). There was no correlation (all P > 0·05) between tumour size and patient age (r = 0·1325), tumour size and duration (r = 0·4433), or tumour size and interval between referral and hospital consultation (r = 0·0695). If the slow growth rate of the average BCC is assumed to be linear, a reduction in referral interval from the mean value of 10·7 weeks in our patients down to the U.K. government target of 2 weeks would equate to a size difference in BCC of 0·7 mm, which is not therapeutically significant. Individual BCCs with rapid growth or other features of concern may require urgent referral, but evidence from our patients and from other studies is that this is not routinely necessary.