New Kiwi Virtual Triage Tech Identifies Skin Cancer In High-Risk Patients

A new virtual triage service developed during lockdown has identified skin cancer in 12% of high-risk patients examined according to new figures.

New Zealand has the world’s second highest rate of melanoma with more than 2,500 new registrations and around 400 Kiwis dying from this form of cancer every year[1].

The new contactless service, designed locally by MoleMap, was used by melanographers in New Zealand and Australia to assess patient lesions remotely and refer high priority cases for further diagnosis and treatment during the lockdown.

The data showed that for every 100 patients screened, 282 suspect lesions were imaged with dermatologists finding a total of 12 skin cancers, including eight melanomas, one of which was a nodular melanoma, the most serious form of skin cancer.

MoleMap, which has the world’s largest database of skin lesions, identifies around 400 new cases of melanoma each year in New Zealand and Australia.

Associate Professor of Medicine and Dermatologist Amanda Oakley says that melanoma can progress quickly and it is critical to diagnose and treat early before the cancer cells enter the bloodstream.

She says while melanoma can be deadly, the prognosis for those identified at an early stage is usually very positive - with a 94% disease-specific five-year survival rate for melanoma less than 1 mm in thickness at the time of excision[2].

“Most melanomas stay for a long time (sometimes decades) in a slow-growing pre-malignant stage (melanoma in situ). But some grow from a dot to a dangerous nodule within a few weeks.

“Once the melanoma has progressed through the skin and into the bloodstream it can spread to other parts of the body where it becomes much harder to treat.

“The lockdown has led to delays in patients presenting for a full body skin check or with concerns about a suspicious lesion, delays in diagnosis by a health professional or referral to an expert, and delays in excision of possible melanoma.

“We are lucky that this amounts only to a matter of weeks in New Zealand, but many people will have experienced great anxiety about their moles,” she says.

Jodi Mitchell, MoleMap chairperson, says the new tech is an easy and inexpensive way to get a spot that concerns a patient evaluated by an experienced skin cancer nurse who can ensure diagnosis and treatment of the most worrying lesions is prioritised.

She says the lockdown has accelerated their development of new virtual skin cancer diagnostic services and enabled MoleMap to offer patient solutions now provided in both a virtual and physical environment.

“MoleMap, which is a skin cancer diagnostic service, was initially not considered an essential service under lockdown.

“We know that a large proportion of melanomas are initially identified by patients themselves and we are now able to use technology to help them have more direction over their care and treatment.

“For patients who have a melanoma a delay in diagnosis can make a difference in treatment outcomes.

“Patients who are concerned about a lesion will soon be able to enter a portal which contains their records and initiate a video call with a specialist melanographer who can help them determine the next steps for treatment or immediately help relieve some of the anxiety they may be experiencing,” she says.

“The new triage service empowers the patient to make sure the lesion that is bothering them can be attended to. However, a full mole map offers a lot more; a full body skin examination — including the areas one can’t see oneself — image archiving of moles that might change in the future, and a dermatologist’s opinion on high-quality clinical and dermatoscopic images,” says Mitchell.

The success of the new diagnostic service has potential applications for those living in rural areas as well as those who are less mobile such as the elderly.

Mitchell says globally telehealth and nurse led health care provision are on the rise and this sector in the past has been slow to adapt to the changing needs of consumers in the modern world.

“Despite being one of New Zealand’s most common forms of cancer we don't have funded surveillance programmes in place to help stop the spread of this preventable disease. COVID-19 has provided us real time opportunity to move towards a more patient centric treatment option which offers us a pathway to build a range of new services in the fight against skin cancer,” she says.

[1] Environmental Health Indicators New Zealand. April 2020. Accessible here.

[2] Lideikaite A, Mozuraitiene J, Letautiene S. Analysis of prognostic factors for melanoma patients. Acta Med Litu. 2017;24(1):25-34. doi:10.6001/actamedica.v24i1.3460. Accessible here.

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