How Is Skin Cancer Detected?

During the consultation with the doctor, there will be an initial discussion of the patient’s symptoms and how long they have experienced them. Questions will also be asked about their lifestyle and family history. The doctor will conduct a physical examination and the relevant further tests to detect the cause.

Step One

Step Two

Step Three

NICE Guidelines: Suspected cancer: recognition and referral (12th January 2026)

Please click the link below to access the NICE Guidelines on skin cancer.

https://www.nice.org.uk/guidance/ng12/chapter/Recommendations-organised-by-site-of-cancer#skin-cancers

Suspected Melanoma Cases

What is the Weighted 7-point checklist?

Major features of the lesions (scoring 2 each)	Minor features of the lesions (scoring 1 each)
Change in size	Largest diameter 7 mm or more
Irregular shape	Inflammation
Irregular colour	Oozing
	Change in sensation

Suspected Basal Cell Carcinoma Cases

Please click the link below:

https://cks.nice.org.uk/topics/skin-cancers-recognition-referral/diagnosis/symptoms-suggestive-of-skin-cancers/

Step Four

Step Five

Types Of Biopsies

Step Six

Eyelid Skin Cancer Staging System

Please click the link below to access Cancer Research UK’s staging system for eyelid skin cancer:

https://www.cancerresearchuk.org/about-cancer/skin-cancer/stages-grades

Cutaneous Squamous Cell Carcinoma

Below is an example of the staging system for cutaneous squamous cell carcinoma.

TNM (tumour–nodes–metastasis) classification for cutaneous squamous cell carcinoma (cSCC) (Keohanne et al., 2020)

T categories
T1	≤ 2 cm in greatest dimension
T2	> 2 to 4 cm in greatest dimension
T3	> 4 cm in greatest dimension or minor bone erosion or specified perineural invasion (≥ 0.1 mm diameter and/or deeper than the dermis and/or a named nerve) or deep invasion (thickness > 6 mm and/or beyond the subcutaneous fat)
T4a	Tumour with gross cortical bone/marrow invasion
T4b	Tumour with skull base or axial skeleton invasion including foraminal involvement and/or vertebral foramen involvement to the epidural space
N categories for non-head and neck
N1	Metastasis in a single node ≤ 3 cm in greatest dimension
N2	Metastasis in a single ipsilateral lymph node, > 3 cm but ≤ 6 cm or in multiple ipsilateral nodes with none > 6 cm in greatest dimension
N3	Metastasis in a lymph node > 6 cm in greatest dimension
N categories head and neck region
N1	Metastasis in a single ipsilateral lymph node ≤ 3 cm in greatest dimension without ENEa
N2a	Metastasis in a single ipsilateral lymph node > 3 cm but < 6 cm in greatest dimension without ENE
N2b	Metastasis in multiple ipsilateral lymph nodes, where none are > 6 cm in greatest dimension without ENE
N2c	Metastasis in bilateral or contralateral lymph nodes, where none are > 6 cm in greatest dimension without ENE
N3a	Metastasis in a single or multiple lymph nodes > 6 cm in greatest dimension without ENE
N3b	Metastasis in a single or multiple lymph nodes with ENE
M categories
M0	No distant metastasis
M1	Distant metastasis (including contralateral nodes in non-head and neck cSCC)

TNM8 (tumour–nodes–metastasis) stage groups for cSCC (Keohanne et al., 2020)

Stage	T	N	M
I	T1	N0	M0
II	T2	N0	M0
III	T3	N0	M0
	T1, T2, T3	N1	M0
IVA	T1, T2, T3	N2, N3	M0
	T4	Any N	M0
IVB	Any T	Any N	M1

Step Seven

Step Eight

Molecular Targets

Molecular Target 1

Molecular Target 2

Molecular Target three

Immunohistochemistry

Step Ten

Step Eleven: Imaging

New Diagnostic Tests

Recommended Sources

Cancer Research UK: Tests to Diagnose Melanoma

https://www.cancerresearchuk.org/about-cancer/melanoma/getting-diagnosed/tests-melanoma

NICE Guidelines: Skin Cancer Diagnosis and Management

https://cks.nice.org.uk/topics/skin-cancers-recognition-referral/diagnosis/symptoms-suggestive-of-skin-cancers/

Radiological Imaging for Skin Cancer Research Journal Article by Russo et al. 2023.

Spotting Cancer: Skin Cancer Guide

Skin Cancer Medical Research Journal Article by Dr. Emily Carter

British Association of Dermatologists guidelines for the management of people with cutaneous SCC

References

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Cambridge University Hospitals (2026) Skin cancer. Available at: https://www.cuh.nhs.uk/our-services/cancer-services/cancer-and-types-of-treatment/cancer-types-a-z/skin-cancer/ (Accessed: 5th February 2026)

 Cancer Research UK (2023a). Stages and grades of skin cancer. Available at: https://www.cancerresearchuk.org/about-cancer/skin-cancer/stages-grades (Accessed: 12^th February 2026)

Cancer Research UK (2023b). Stages of cancer. Available at: https://www.cancerresearchuk.org/about-cancer/what-is-cancer/stages-of-cancer (Accessed: 12^th February 2026)

Cancer Research UK (2026a) Kaposi’s sarcoma (Kaposi sarcoma cancer). Available at: https://www.cancerresearchuk.org/about-cancer/soft-tissue-sarcoma/types/which-treatments-are-used-for-kaposis-sarcoma (Accessed: 5th February 2026)

Cancer Research UK (2026b) Sebaceous gland carcinoma. Available at: https://www.cancerresearchuk.org/about-cancer/skin-cancer/types/sebaceous-gland-carcinoma (Accessed: 5th February 2026)

Cancer Research UK (2026c) Skin Lymphoma Cutaneous T cell lymphoma (CTCL Available at: https://www.cancerresearchuk.org/about-cancer/non-hodgkin-lymphoma/types/skin (Accessed: 5th February 2026)

Cancer Research UK (2026d) Tests for melanoma skin canc..er Available at: https://www.cancerresearchuk.org/about-cancer/melanoma/getting-diagnosed/tests-melanoma (Accessed: 11^th February 2026)

Cancer Research UK (2026e) Types of non-melanoma skin cancer. Available at: https://www.cancerresearchuk.org/about-cancer/skin-cancer/types (Accessed: 5th February 2026)

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Cancer Research UK (2026g)….kel cell carcinoma (MCC). Available at: https://www.cancerresearchuk.org/about-cancer/neuroendocrine-tumours-nets/types/merkel-cell-skin-cancer (Accessed: 5^th February 2026)

GeneCards (2026) TYRP1 -Gene-Tyrosinase Related Protein 1. Available at: https://www.genecards.org/cgi-bin/carddisp.pl?gene=TYRP1#summaries (12^th February 2026)

Harada, K. and Ogden, G.R. (2000). An overview of the cell cycle arrest protein, p21WAF1. Oral Oncology, 36(1), pp.3–7. doi:https://doi.org/10.1016/s1368-8375(99)00049-4.

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‌Kanjoormana Aryan Manu, Anh, H., Tin Fan Chai, Casey, P.J, and Mei Legam Wang (2019). p21cip1/waf1 Coordinates Autophagy, Proliferation, and Apoptosis in Response to Metabolic Stress. Cancers 11(8), pp.1112–1112. doi:https://doi.org/10.3390/cancers11081112.

Keohane, S.G., Botting, J., Budny, P.G., Dolan, O.M., Fife, K., Harwood, C.A., Mallipeddi, R., Marsden, J.R., Motley, R.J., Newlands, C., Proby, C., Rembielak, A., Slater, D.N., Smithson, J.A., Buckley, P., Fairbrother, P., Hashme, M., Mohd Mustapa, M.F., and Exton, L.S. (2021). British Association of Dermatologists guidelines for the management of people with cutaneous squamous cell carcinoma 2020*. British Journal of Dermatology, 184(3), pp.401–414. doi:https://doi.org/10.1111/bjd.19621.

National Health Service (2022).Lactate dehydrogenase (LDH) test. Available at: https://www.nhs.uk/tests-and-treatments/ldh-test/ (Accessed: 11^th February 2026)

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Updated February 2026  Next Review May 2028

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