Determining the diagnostic Utility of AMBLor for Classification of Atypical pigmenTed lesioNs in the Ageing Population (CATNAP)

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People are living longer than they did 100 years ago but many spend their later years in poor health. The attention in healthcare is mainly on the prevention of diseases such as skin cancer, by encouraging people to protect their skin from the sun. For older people this can be too late as they will already have signs of skin damage in the form of brown/black growths that they may worry are cancer.Currently the main way to test if these growths are cancer or not, is to cut out them out, and have them assessed by a pathologist. Most growths can be classified as cancerous or not cancerous, but for some growths it is difficult to tell from looking under the microscope alone so analysis of DNA is carried out. This can be uncertain and is expensive. Inability to determine whether the growth is cancer of not may result in following up the person for numerous appointments to look out for any signs of cancer. This can be stressful for people, and for older people particularly, this may be worse as they may be less able to attend the follow-up appointments and undergo treatments due to their other medical conditions, because they are less mobile, or because they are unable to travel.We already have a test which is used for melanoma (a type of skin cancer) to pick out those tumours which are least likely to spread. It looks for the presence or absence of two proteins in the skin overlying the tumour. We have also used this test to look at a variety of clinically worrying brown/black skin growths, and this suggested that the test could be used to identify those growths which are not cancers. This would allow medical teams to give people to correct results and the right treatments.In this new study, we will look at a large number of brown/black growths which are common in the elderly, and test whether we can correctly pick out those growths which are not cancer. This will support the development of the test as a product which can be used in pathology labs to pick out the growths which are not dangerous. People with growths which are not dangerous would not have to attend unnecessary hospital appointments, which will reduce stress, and save money for the NHS and other healthcare providers around the world.