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Timeliness of diagnosis and treatment of cutaneous melanomawith dermatology, general practice, plastics surgerycollaboration – are we meeting standards?

By October 18, 2023January 30th, 2024No Comments

Haein NaA and Amanda Oakley

Introduction. Melanoma is a serious type of skin cancer with a high burden in New Zealand.
MelNet Quality Statements (2021) guide the timeliness of investigations and management for
melanoma patients, who might experience long delays waiting for treatment. Aim. To assess
compliance of melanoma diagnosis and treatment timeliness with the MelNet Quality Statements
at Waikato Hospital and in primary care for melanoma and melanoma in situ (MIS).

Methods. This is a retrospective clinical audit of patients referred via the Suspected Skin Cancer (SSC) teledermatology pathway between June 2020 and June 2022, and histologically confirmed as having melanoma or MIS. Time intervals between elements of service were analysed.

Results. For 43 melanomas and 105 MIS, compliance with MelNet Quality Statements across all melanoma services was poor, except for teledermatology response rates (100% compliance). From referral to first cancer treatment (Statement 2.1.1), compliance was 50% in general practice and 7.7% in Waikato Hospital. From teledermatologist response to biopsy (Statement 2.1.3), compliance was 65.2% in general practice
and 7.7% in hospital plastics department. Histopathological reporting delays were also identified.

Discussion. Long delays for melanoma care in hospital likely reflect system failures (such as
inadequate funding and human resources) and the increasing burden of skin cancer. In contrast,
primary care provided quicker diagnostic biopsies and surgical treatments for melanoma.

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