In June 2014, work began on a UK programme of systematic reviews on the diagnosis and staging of skin cancer funded by the National Institute for Health Research (NIHR).
The suite of over 20 diagnostic test accuracy reviews is a collaboration between the content expertise of the Cochrane Skin Group, based at Nottingham, and the methodological expertise of the Biostatistics, Evidence Synthesis and Test Evaluation team in Birmingham. The aim of the programme is to extensively investigate available resources and literature in order to produce definitive reviews on both the diagnosis and staging of melanoma and keratinocyte skin cancers (basal cell and cutaneous squamous cell carcinomas, also termed 'non-melanoma' skin cancers). Some overviews will also be created to inform policy, such as National Institute for Health and Care Excellence (NICE) Guidelines.
The project is being led by Dr Jac Dinnes from the Birmingham team and is scheduled to run for the next two years.
The two generic protocols, which are forming the foundation for the project, have now been published. These two protocols, ‘Tests to assist in the diagnosis of cutaneous melanoma in adults: a generic protocol’ and ‘Tests to assist in the diagnosis of keratinocyte skin cancers in adults: a generic protocol’, will form the basis for the development of the suite of 11 diagnostic test reviews on skin cancer (a Health of the Nation target). Two protocols for the staging reviews have also been published: 'Tests to assist in the staging of cutaneous melanoma: a generic protocol' and 'Tests to assist in the staging of cutaneous squamous cell carcinoma: a generic protocol'.
Before peer review, the reviews will be presented to a senior Advisory Group, made up of various stakeholders including oncology, plastic surgery, patient support groups, and primary care (see box to the left of the page), to make sure that the correct questions are addressed in the right way and that the limited evidence has been interpreted appropriately.
The text on this page was partly written by BAPRAS Representative , Mr Hamid Tehrani, Consultant Plastic and Reconstructive Surgeon with the Regional Specialist Skin Cancer Multidisciplinary team, Whiston and St Helens, UK.
List of reviews (revised June 2017)
Diagnosis of cutaneous melanoma
2. Visual inspection
3. Smartphone applications
4. Reflectance confocal microscopy
5. Computer-aided diagnosis – spectroscopy-based techniques (combined with keratinocyte skin cancer)
6. Reflectance confocal microscopy (combined with keratinocyte skin cancer)
7. Teledermatology (combined with keratinocyte skin cancer)
8. Overview: Comparing the accuracy of tests for which sufficient evidence is identified either alone or in combination
Diagnosis of keratinocyte skin cancer (BCC and cSCC)
9. Visual inspection versus visual inspection and dermoscopy
10. Optical coherence tomography
11. Reflectance confocal microscopy
12. Exfoliative cytology
13. Overview: Comparing the accuracy of tests for which sufficient evidence is identified either alone or in combination
Staging of melanoma
16. PET or PET-CT
18. Sentinel lymph node biopsy +/- high frequency ultrasound
19. Overview: Comparing the accuracy of tests for which sufficient evidence is identified either alone or in combination
Staging of cSCC
20. Imaging tests review
21. Sentinel lymph node biopsy +/- high frequency ultrasound