P206 Conversion rates for urgent suspected skin cancer referrals in England 2009–2023

Abstract

Skin cancer is the most common cancer, with an increasing incidence worldwide. The main types are basal cell carcinoma, squamous cell carcinoma and melanoma. Our aim was to understand the national trends in referral and conversion rates for urgent suspected skin cancer referrals and to identify variation across demographic groups (age, gender, ethnicity, region and deprivation). Data were extracted from the open-source dashboard of aggregated Cancer Waiting Times data presented by the National Disease Registration Service. Conversion rates (i.e. the proportion of referrals confirmed to be a skin cancer excluding basal cell carcinomas) for urgent suspected skin cancer referrals were obtained by financial years, 2009–2023. Deprivation is reported as Index of Multiple Deprivation (IMD) quintiles. Statistical analysis was performed using a χ2-test of independence using MedCalc software (v.23.4.5). Across 2009–2023, urgent suspected skin cancer referrals in England increased from 159 431 to 634 970 (+298%), while conversion rates fell from 8.3% to 6.2%. Conversion rates were highest in the least deprived quintile and lowest in the most deprived quintiles (8.1% vs. 6.0%, P < 0.001). Regarding ethnicity, those self-reporting as ‘White’ ethnicity had significantly higher conversion rates (7.8%) than those with all other ethnicities. ‘Asian’ ethnicity showed the lowest conversion rate (0.7%, P < 0.001). Male patients had a higher conversion rate (9.7%) than female patients (5.6%, P < 0.001). The highest conversion rates were seen in those aged > 80 years (16.2%) , compared with < 50 years (2.1%, P < 0.001). Regional variation showed that the ‘Peninsula’ cancer alliance had the highest conversion rates (10.7%), while ‘North Central London’ had the lowest (3.4%, P < 0.001). In our univariate analysis, national data for suspected skin cancers indicate higher conversion rates in those who were older, of White ethnicity, male and the least deprived, reflecting those populations with the highest incidence rates. Regional variations in referral and conversion rates were identified. These referral patterns may help inform targeted skin cancer detection strategies.