Skin Cancer Referrals by Non-Medical Practitioners: A Prospective Observational Study.

The aim of this study was to investigate the appropriateness of suspected skin cancer referrals made by non-medical practitioners (NMPs) and compare this to referrals made by local General Practitioners (GPs). Data were collected prospectively from patients referred to a UK hospital dermatology department from primary care. The profession of the referrer was ascertained from review of referral letters and direct questioning. Patient records and subsequent histology reports were reviewed to determine ultimate diagnosis. 668/753 patients (88.7%) were referred by GPs versus 85/753 (11.3%) by NMPs. 340/668 (50.1%) of patients in the GP group and 47/85 (55.3%) in the NMP group were discharged without intervention (p = 0.45). An ultimate diagnosis of skin malignancy was made in 196/668 (29.3%) patients in the GP and 25/85 (29.4%)) in the NMP group (p = 0.99). These early data suggest significant potential for NMPs to become more involved in skin lesion assessment.