Short summary

This project aims to make it easier and faster to diagnose Malignant Melanoma and nonmelanoma skin cancer and thereby ensure faster treatment of the patients, reducing the risk of cancer spreading and fatal outcomes.

Rationale

Malignant Melanoma has been on the rise since the start of the Cancer Registry, and in 2020, there were approx. 4000 cases in Denmark. Practicing Dermatologists handle the filter function following the updated recommendations from the National Board of Health's description of package procedures for Malignant Melanoma and thus oversee the screening of many thousands of patients annually after a referral from primary care physicians. Nonmelanoma skin cancer is also rising rapidly, and the Skin Cancer Database shows that in 7 years, there has been a doubling in the number of cases among practicing dermatologists. The latest annual report shows that practicing dermatologists diagnosed more than 35,000 cases of skin cancer. The explosive increase in the number of cases of both Malignant Melanoma and nonmelanoma skin cancer is a growing burden for practicing dermatologists and displaces, thus delaying the assessment, diagnosis, and treatment of the diseases. In addition, it is problematic for the approx. 25-28% routinely referred patients with Malignant Melanoma because they have to wait approximately twenty-four weeks before getting an appointment with a practicing Dermatologist. Very precious time is lost here. Recent research has shown that doctor-to-doctor teledermatology between primary care physicians and hospital dermatologists is safe. In addition, teledermatology is very fast and independent of the geography of both patient and dermatologist compared to a regular referral and physical attendance. To solve the above challenge, we want to implement a new digital platform at 50 primary care physicians' offices and 10 practicing dermatologists' offices as we test the safety of triaging by teledermoscopy. We want to do it with special attention to pigmented skin lesions because, in the case of malignancy, these have the most malignant potential of all skin cancers. When the primary care physician sees a patient with a suspicious skin lesion, he or she will take three photographs via an Iphone with a dermoscopy attached and send them securely and encrypted in an app to a practicing dermatologist. Within 48 hours, the primary care physician will have an answer and a diagnosis to tell the patient.

Description of the cohort

We have included approximately 1300 patients with a skin lesion of concern in our project.

Data and biological material

Clinical photos of the skin lesion and data from the patients medical journal.

Collaborating researchers and departments

Department of Dermatology, Odense Univercity Hospital

• Tine Vestergaard
• Bettina Trettin

Research Department of General Medicine, Odense Univercity Hospital

• Merethe Kirstine Andersen

Private Dermatological Practice

• Henrik Sølvsten