Smartphone and skin cancer diagnostics

Smartphones provide faster diagnosis and treatment of skin cancer

dermascope

In 2013, the Swedish Association of Local Authorities and Regions (SKL) funded a pilot project seeking to develop a more efficient and patient-focused system for the diagnosis and treatment of suspected malignant skin tumors. The pilot looked at a new skin cancer referral system based on teledermoscopy. One hundred and twenty-two General Practitioners from 20 health care centers and two dermatology clinics – Sahlgrenska University Hospital (SU) and Skaraborgs hospital (SkaS) from the region of Västra Götaland – collaborated in the pilot. So far, 747 patients have been included in the teledermoscopy group and 880 patients in the traditional paper-referral group (the control group).

Using the built in camera in a regular smartphone (iPhone) with a customized dermoscope (a magnifying glass with a light source), digital referrals with pictures were sent directly to dermatologists from the health care centers, through a specially developed IT application in the smartphone. Within 24-48 hours, the assessing dermatologist responded directly to the General Practitioner’s (GP) smartphone with a preliminary diagnosis and recommendation on whether or not the patient would need to see a dermatologist, and whether or not surgical treatment would be necessary.

The preliminary results show that mobile teledermoscopy shortens waiting times for skin cancer patients to their first dermatologist appointment. Patients with life-threatening skin cancer can have surgery much earlier when using this method. Furthermore, patients found to have harmless skin lesions can have an answer within 48 hours instead of worrying for weeks or months.

Finally, the method introduces the General Practitioner to skin cancer diagnostics and improves communication between the specialists.

Preliminary results

  1. Reduces waiting times for a first visit to the dermatologist for patients with confirmed malignant skin tumors.
  2. Significantly reduces waiting times for surgical treatment of patients with various forms of skin cancer (malignant melanoma, malignant melanoma in situ, and squamous cell carcinoma).
    1. Melanoma                              Teledermatology: 14 days vs. control: 46 days
    2. Melanoma in situ                  Teledermatology: 15 days vs. control: 65 days
    3. Squamous cell carcinoma   Teledermatology: 23 days vs. control: 40 days
  3. Allows significantly more patients with malignant melanoma, malignant melanoma in situ, squamous cell carcinoma, and basal cell carcinoma to be offered the necessary surgical treatment on their first visit to the dermatologist, which saves both the patient and healthcare provider unnecessary additional visits.
  4. Reduces proportion of falsely “high” priority referrals that might cause a shortage of urgent dermatologist appointments.
  5. Allows a response and feedback to the GP and the patient with a preliminary diagnosis and information on the planned treatment within 24-48 hours.
  6. Creates an opportunity for GPs ​​to improve their skin cancer diagnosis through rapid feedback on dermoscopy findings.
  7. Gives access to digital skin cancer images for educational use.

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