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Skin cancer referral rule 'too imprecise'

Guidelines on how to use the two-week rule for referring suspected skin cancers are imprecise, causing GPs to play safe and over-refer patients, new research suggests.

A survey of 139 consultant dermatologists and dermatology departments published in the British Journal of Dermatology (February) found only a third of consultants thought the information supplied by GPs was adequate and nearly three-quarters felt the two-week referral rule was not working well.

But study author Dr Neil Cox, consultant dermatologist at Cumberland Infirmary in Carlisle, found there were 'significant problems in the perception and application of the two-week referral standard for possible skin cancers'.

Using information from secondary care databases and formal audits, the research found skin cancer was confirmed in only 12 per cent of urgently referred cases.

The study tallies with previous research showing very low rates of skin cancer among urgently referred patients. It also found only 42 per cent of all diagnosed skin cancers went through the two-week route.

Dr Cox concluded: 'There are significant problems with the perception and application of the two-week referral standard for possible skin cancers, including a high volume of non-relevant lesions and displacement of other urgent conditions.'

He suggested the guidelines on referral should be made more specific.

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