Scottish referral guidelines for suspected cancer: quick reference guide

Scottish Referral Guidelines for Suspected Cancer is a quick reference guide for cancer referrals.

Skin Cancers


Pigmented lesions on any part of the body which have one or more of the following features:

  • Rapid growth in height or area.
  • Change in colour or more than three colours at presentation.
  • Lesion which is significantly different from patient's other moles.
  • Growing subungual lesions.
  • Lesion with persistent surrounding inflammation or altered sensation.
  • Persistent ulceration, bleeding or oozing in absence of trauma.
  • New growing nodule whether pigmented or not.

Squamous Cell Carcinoma

Urgent referral for:

  • Lesions which grow rapidly over 6 weeks, especially on ear, columella or lip.
  • Slow growing, non-healing lesions with induration (esp. face, scalp, back of hand) expanding over 1-2 months.
  • If invasive SCC diagnosed from biopsy undertaken in general practice.
  • Patients who are immunosuppressed especially after organ transplantation have a higher incidence of aggressive SCC with metastatic potential compared to immune competent patients.

Basal Cell Carcinoma

  • The majority of BCCs do not need urgent referral.
  • Lesions with very long history (>10 years) have the potential to metastasise.
  • Urgent referral for recurrent BCC and those invading potentially dangerous areas, e.g. auditory meatus, eye, base of nose or any major vessel.
Back to top