Rate of positive diagnosis of skin cancer and its stage in two-week wait referrals in England according to age

D. J. Keith*, T. Jones, A. Ives, D. de Berker, Julia Verne

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review


    Background: The incidence of skin cancer is increasing. The two-week wait conversion rate (TWWCR) is the percentage of urgent suspected skin cancer referrals that are confirmed as cancer. Aims: To examine the relationships between different epidemiological factors and TWWCR for malignant melanoma (MM) and cutaneous squamous cell carcinoma (SCC). Methods: We extracted data from the National Cancer Data Repository (NCDR) and National Cancer Waiting Times Monitoring Dataset between 2009 and 2010 for MM and SCC in England. We conducted partial correlation and stepwise multiple regression analysis on TWWCR, age, incidence, detection rate, tumour thickness (MM only), percentage MM/SCC and social deprivation. We also looked at the two-week wait referral rate (TWWRR) and incidence rate with respect to age. Results: TWWCR was significantly correlated with age when partial correlation was used to control for the factors described above for MM (P < 0.05) and SCC (P < 0.001). Stepwise regression of these factors returned only age as significant in the final model for MM (P < 0.001) and SCC (P < 0.01). Incidence of MM and SCC increased with age. TWWRR also increase with age, but with higher rate in younger people relative to their incidence. Conclusions: Age is a predictor of TWWCR independent of the other factors measured, including thickness and incidence. This may be explained by the higher number of referrals for younger patients despite the lower incidence of skin cancer in this group. This may reflect a more appropriate rate of referral in order to achieve earlier diagnosis and better outcomes.

    Original languageEnglish
    Pages (from-to)145-152
    Number of pages8
    JournalClinical and Experimental Dermatology
    Issue number2
    Publication statusPublished - 1 Mar 2017

    Bibliographical note

    Publisher Copyright:
    © 2017 British Association of Dermatologists


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