INTRODUCTION. Timely diagnosis of malignant melanoma (MM) is crucial for optimal patient outcomes. Thus, the Danish Health Authority implemented a fast-track referral system (FTRS) comprising a clinical diagnostic filter function (CDFF) and a cancer package. This study aimed to characterise the flow of patients with a tentative MM diagnosis referred through the CDFF to a department of dermatology. METHODS. Retrospective data from the Danish patient and pathology file system were analysed for patients referred to the Department of Dermato-Venereology at Bispebjerg Hospital, Denmark, via the CDFF, with suspected MM in a one-year period. RESULTS. Among 860 patients with 895 skin lesions, 283 (31.6%) were discharged with a clinical benign diagnosis after their initial consultation, whereas treatment of another 77 (8.6%) patients concluded following a three-month observation period. One-year follow-up of these 360 (283 + 77) clinically benign skin lesions showed no malignancy. Among 100 MM-suspicious lesions promptly referred for excision to a department of plastic surgery, 48% were MM. CONCLUSIONS. In a Danish population with tentative MM diagnosis referred through the CDFF to a dermatological hospital department, one-third of patients were discharged with a clinically benign diagnosis. Half of the skin lesions referred for excision to the department of plastic surgery were MM. This indicates a decreased burden of overdiagnosis and a potential reduction of unnecessary surgical scars when dermatologists serve as gate keepers of the FTRS for MM. FUNDING. None TRIAL REGISTRATION. Data obtained with permission from BBH j. no. 20078406.
Published under Open Access CC-BY-NC-BD 4.0. https://creativecommons.org/licenses/by-nc-nd/4.0/.