Short summary

The project Ram Plet Første Gang is a prospective study that aims to improve the course of treatment for patients with non-melanoma skin cancer through citizen involvement. We will utilize the smartphone application "Mit Sygehus" to invite patients to upload photographs of their skin lesions. Our hope is that this will ease the referral and visitation process and faciliate that more patients can be examined and operated on the same day.

Rationale

Background Non-melanoma skin cancer (NMSC) is the most frequently diagnosed cancer in Denmark, with more than 20,000 new cases each year. The disease primarily affects people over 60 years of age. NMSC can be anatomically located anywhere on the body, but most often occurs on sun-exposed places, such as the face, scalp, neck and forearms. Left untreated, the cancer can cause extensive tissue damage with bleeding and painful wounds as well as invading into underlying structures such as fat, nerves, muscles and bones. In rare cases, the disease can metastasize.

Introduction The plastic surgery section at Vejle Hospital receives around 1,000 referrals for patients with non-melanoma skin cancer annually. When patients with NMSC are referred to the department of plastic surgery we generally assign them into one of three clinical pathways 1. Simple surgery - one consultation in the operating room to examine and treat the patient 2. Surgery with reconstruction - outpatient clinic prior to surgery, surgery scheduled on another day 3. Discussion at multidisciplinary team conference, since other treatment options should be considered (e.g. oncology) Patients in Pathway 2, however, are often found at physical examination to be suitable for Pathway 1, and this group would obviously benefit from a more accurate pathway allocation in the first place. Allocation of patients may be improved if more information on tumor size and anatomical site is available at the time of preadmission assessment. A simple smartphone photograph may provide both. The Region of Southern Denmark already supports a mobile application "Mit Sygehus" which allows for upload of photos. We will develop and test the use of this technology to improve allocation at the time of referral.

Aim To adapt "Mit Sygehus" to allow NMSC patients to provide surgeons with a photo of their skin cancer to optimize correct treatment allocation and avoid unnecessary outpatient visits.

Description of the cohort

The cohort will consist of all patients referred to the Plastic Surgery Section at the Department of Surgery, Vejle Sygehus with a diagnosis of NMSC in the project period. The patients in Pathway 2 are designated the main project group, will the patients in Pathway 1 and 3 will work as a control group.

Data and biological material

We will collect demographic data, data on primary and secondary allocation, data on final treatment and data on type and location of the skin lesion from the patients journal. In addition, we will collect data on the patients satisfaction through a targetted questionnaire. We will not collect any biological material.