'Fast-tracking' cancer referrals: application for periocular basal cell carcinoma.
OBJECTIVE
To study the feasibility of a modified fast-track protocol for periocular basal cell carcinoma (BCC).


METHODS
A modified protocol was set up with an aim to examine all periocular BCCs within 6 weeks of referral to our oculoplastic clinic. An audit of this protocol was performed over a 2-year period.


RESULTS
A total of 65 patients were referred as a 'possible BCC' over the 2-year period. In all, 32 of these patients were referred by dermatologists (49%), followed by fellow consultant ophthalmologists (20 patients, 31%) and general practitioners (11 patients, 17%). The clinical suspicion in the oculoplastic clinic agreed with the referral diagnosis in 71% (46 of the 65) of patients. This figure was particularly high for referrals from dermatologists (84%). In all, 44 out of the 46 'clinically suspected BCC' underwent surgical excision. Histopathology confirmed BCC in 39 of these 44 patients, a diagnostic accuracy of 89%. Among the subgroup of patients referred by the dermatologists, the largest source of referrals, 24 out of 30 patients that underwent surgical excision had histologically proven BCC; a diagnostic accuracy of 80%.


CONCLUSIONS
Our study shows that the modified fast-track protocol for periocular BCCs is practical and feasible. Such a practice is highly desirable since it prevents a long wait for patients who are aware of a possible malignant periocular lesion.
Bhatnagar
A
A
Wolverhampton Eye Infirmary, Wolverhampton, UK. bhatnagar_ajay@hotmail.com
Mohamad
S
S
Sandramouli
S
S
D002280:Basal Cell Carcinoma / Q000175:diagnosis* / Q000601:surgery; D002985:Clinical Protocols; D003880:Dermatology / Q000458:organization & administration; D005142:Eyelid Neoplasms / Q000175:diagnosis* / Q000601:surgery; D005194:Family Practice / Q000458:organization & administration; D005240:Feasibility Studies; D006302:Health Services Research; D006801:Humans; D008485:Medical Audit; D012017:Referral and Consultation / Q000458:organization & administration*