mPatch: a rapid test for improving diagnosis and triage of melanoma patients in primary care

皮肤癌是所有癌症中最常见的，对女性和男性的影响几乎是一样的。病例数量正在迅速增加，包括黑色素瘤，这是最致命的皮肤癌之一。尽管皮肤癌的诊断方法非常主观和低效，但近年来几乎没有演变。目前的诊断方式：初级保健的初始诊断通常始于全科医生的目测检查，寻找可疑葡萄胎或病变的身体异常。如果看起来可疑，全科医生会建议皮肤科医生紧急转诊两周(2WW)，然后皮肤科医生会做更全面的视觉检查，然后做皮肤活检。然后，活检将被送往进行漫长而昂贵的分析，然后才能做出最终诊断。虽然绝大多数(&gt；94%)的黑色素瘤患者被送到2WW转诊途径，但96%的人在这条途径上没有黑色素瘤。这会造成不必要的压力和伤疤，也会让NHS付出高昂的代价。每年仅在皮肤癌的不必要诊断程序上就花费了超过3500万GB。需要一种新的、主观性更低的测试：因此，迫切需要新的诊断测试来帮助初级保健的临床医生提高转诊质量。减少不必要地被送到2WW路径上的健康人的数量也有助于减轻皮肤科医生目前的压力。我们的解决方案是为全科医生提供一种新的负担得起的无痛设备，与视觉检查一起使用，以获得更可靠的诊断。无痛皮肤贴片和24小时内的结果：无痛贴敷在可疑皮肤病变附近，我们的皮肤贴片将收集皮肤液中包含的癌症特异性分子。然后，它将被送往中央实验室进行快速(24小时)分析，类似于Covid检测。凭借与皮肤活检相当的准确性，我们的测试将帮助全科医生识别需要紧急干预的皮肤癌患者。在这个项目中，我们将通过实验证明我们对皮肤科医生采集和分析的人类皮肤活检组织进行测试的可行性和准确性。在开发我们的原型时，我们还将与全科医生和患者团体接触。这是为了确保它被很好地接受，并能迅速被纳入国民健康保险制度内目前的皮肤癌诊断途径。

Cancers of the skin are the most common of all cancers and affect almost equally women and men. The number of cases is increasing rapidly, including for melanoma, one of the deadliest forms of skin cancer. The way skin cancers are diagnosed has barely evolved in recent years despite being very subjective and inefficient.How they are currently diagnosed: Initial diagnosis in primary care typically begins with a visual inspection by a GP, looking for physical abnormalities of a suspected mole or lesion. If it looks suspicious, the GP will recommend an urgent 2-week-wait (2WW) referral with a dermatologist who will then do a more thorough visual examination and then do a skin biopsy. The biopsy will then be sent for a lengthy and costly analysis before a final diagnosis can be made. Although the large majority (>94%) of melanoma patients are sent on the 2WW referral pathway, 96% of people sent on this pathway do not have melanoma. This causes unnecessary stress and scarring and is also very costly to the NHS. Over £35 million are spent every year on unnecessary diagnostic procedures for skin cancer only.The need for a new, less subjective test: There is therefore an urgent need for new diagnostic tests that can help clinicians in primary care improve the quality of their referral. Reducing the number of healthy people sent unnecessarily on the 2WW pathway with also help reduce the current pressure on dermatologists. Our solution is to provide GPs with a new affordable and painless device to be used alongside visual inspection for a more informed diagnosis.A painless skin patch and a result within 24h: Painlessly applied near the suspicious skin lesion, our skin patch will collect cancer-specific molecules contained within the skin fluid. It will then be sent to a centralised lab for a rapid (24h) analysis similar to that done for Covid testing. With an accuracy comparable to that of a skin biopsy, our test will help GPs identify those skin cancer patients that require urgent intervention. In this project, we will experimentally demonstrate the feasibility and accuracy of our test on human skin biopsies taken and already analysed by dermatologists. We will also engage with GPs and patient groups when developing our prototype. This is to ensure it is well accepted and can be rapidly included into the current skin cancer diagnostic pathway within the NHS.