Hi,

NICE advise GPs to use the 7 point checklist when deciding on whether to refer the patient to dermatology. It's a points system that is explained here.

If your mole has changed in size & colour it means it's scored 4 points - 3  or more points means a referral to dermatology. It doesn't mean it's definitely melanoma but it gives them a framework to use. GP's rarely have an idea if it's malignant because they have very little training in the complexities of melanoma. A dermatologist sometimes even gets it wrong as moles can look dodgy but turn out to be dysplastic (precancerous). So that's why GP's are the 'triage system' when deciding on a referral. The 2 week suspected cancer pathway is used because melanoma needs catching as early as possible to ensure a successful treatment. A standard referral (which is used for non melanoma skin cancers like basal cell & squamous cell) would mean a wait of several months & that's too long to wait.

At the appointment the dermatologist will examine your moles using a dermatascope - a handheld microscope/camera. This shows them if the cell structure of the mole is changing. If it is, it needs removing for a biopsy (the only 100% way of diagnosing melanoma). 75% of patients seen by dermatology are either discharged after the dermatascope shows no change in cell structure or their mole is removed for biopsy & the results show it was a dysplastic mole. These are 'ugly ducklings' that, if left in situ, have the ability to turn malignant in the future. If the dermatascope shows the cell structure is changing, you will be advised to have the mole removed for a biopsy. They usually send you an appointment to go in as a day patient & it's removed under a local anaesthetic. Results can take a few weeks to come back.

With regard to waiting time for the initial appointment - it used to be within the 2 week timescale (before Covid) - now, they aim to send you a letter within the 2 week timescale & the appointment date can be within another week or two - it really depends on the waiting lists at the individual hospital trusts. I suggest that, if you haven't received a letter with an appointment date by the end of the 2 week timescale, give the Dermatology department a ring at your local hospital to ensure they have received the GP referral & for an indication as to how much longer you will have to wait.

I hope this helps. Good luck & please let us know how you get on,

Angie (Stage 3 melanoma patient since 2009)