Skin Cancer – Recognition and Referral
NICE CKS Skin cancers – recognition and referral. Last revised: Apr 2025.
NICE guideline [NG12] Suspected cancer: recognition and referral. Last updated: May 2025.
Guidelines
Suspected Malignant Melanoma
Suspected cancer pathway referral if there is:
- A pigmented skin lesion with ≥3 on weighted 7-point checklist score, or
- Dermoscopy suggests melanoma
- Nodular melanoma suspected (consider)
Weighted 7-point checklist:
- Major features (2 points each)
- Change in size
- Irregular shape
- Irregular colour
- Minor features (1 point each)
- ≥7mm (largest diameter)
- Inflammation
- Oozing
- Change in sensation
Suspected Squamous Cell Carcinoma
Consider a suspected cancer pathway referral if there is a suspected squamous cell carcinoma skin lesion.
Suspected Basal Cell Carcinoma
Consider routine referral (to dermatology) if there is a suspected basal cell carcinoma skin lesion.
Since basal cell carcinoma is less dangerous, it only warrants routine referral, while malignant melanoma and squamous cell carcinoma warrant suspected cancer pathway referral.
References
Original Guideline