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australia clinical guidance

Skin cancer recognition and referral

A detailed Australian summary of skin cancer recognition and referral, with source-attributed priorities, a practical workflow, safety escalation and state or territory implementation boundaries.

JurisdictionAustralia
Source check2026-08-20
Clinical reviewiatroX editorial team 路 Clinical editorial review 路 reviewed 2026-08-20 路 due 2027-08-20
AudienceHealthcare professionals practising in Australia
This is an iatroX educational summary of named Australia sources, not an official guideline. It does not replace the complete source documents, local policy, specialist advice or clinical judgement. Apply current TGA product information, PBS restrictions, state or territory law, local referral criteria, formulary and antimicrobial policy. A national recommendation does not create uniform service access.

Scope

Perform full lesion assessment using change, asymmetry, border, colour, diameter, symptoms and the ugly-duckling sign alongside personal risk. Use dermoscopy when trained and document site, dimensions and image with consent, but do not let photography delay biopsy of a suspicious lesion. This summary is limited to the population, decisions and escalation boundaries stated in the named source.
sources for this section:Cancer Council melanoma guidelineCancer Council keratinocyte guideline

The Bottom Line

  • Perform full lesion assessment using change, asymmetry, border, colour, diameter, symptoms and the ugly-duckling sign alongside personal risk.
  • Use dermoscopy when trained and document site, dimensions and image with consent, but do not let photography delay biopsy of a suspicious lesion.
  • Nodular melanoma may lack the classic ABCD pattern and is suggested by elevation, firmness and progressive growth.
  • Suspected melanoma should undergo complete excision biopsy with appropriate narrow clinical margin by a capable clinician or urgent specialist referral.
sources for this section:Cancer Council melanoma guidelineCancer Council keratinocyte guideline

Practical clinical workflow

1

Topic-specific assessment action

Perform full lesion assessment using change, asymmetry, border, colour, diameter, symptoms and the ugly-duckling sign alongside personal risk.
2

Topic-specific diagnostic action

Suspected melanoma should undergo complete excision biopsy with appropriate narrow clinical margin by a capable clinician or urgent specialist referral.
3

Topic-specific management action

Refer high-risk keratinocyte cancer by site, size, recurrence, histology, nerve symptoms and immune status under the Australian pathway.
4

Topic-specific follow-through

Immunosuppressed transplant recipients need lower referral thresholds and coordinated surveillance for aggressive keratinocyte cancer.
sources for this section:Cancer Council melanoma guidelineCancer Council keratinocyte guideline

Safety boundaries and escalation

  • Rapid growth, bleeding, ulceration, nodal disease, neurological symptoms or a lesion threatening eye, ear or major function requires expedited care.
  • Avoid shave biopsy when it prevents accurate Breslow depth in a lesion suspicious for invasive melanoma.
sources for this section:Cancer Council melanoma guidelineCancer Council keratinocyte guideline

Implementation

The named source is national or binational guidance used in Australia, but referral access, public-health directions, formularies and funded services can still differ by state, territory and health service. Check current TGA product information for medicines. Offer culturally safe care and use the NACCHO鈥揜ACGP National Guide where Aboriginal and Torres Strait Islander preventive or chronic-care recommendations differ.
sources for this section:Cancer Council melanoma guidelineCancer Council keratinocyte guideline

Clinical use boundary

This independently written summary is not an official guideline. Check the linked source version, current TGA-approved product information where medicines are involved, and the applicable state, territory and local pathway at the point of care.

sources for this section:Cancer Council melanoma guidelineCancer Council keratinocyte guideline

Source documents

Use the linked source documents for complete recommendations, evidence grading, exclusions and implementation detail.

  1. Cancer Council AustraliaClinical practice guidelines for the diagnosis and management of melanomaLiving web guideline; current version checked 2026-08-20 路 accessed 2026-08-20
    view source
  2. Cancer Council AustraliaClinical practice guidelines for keratinocyte cancer2019 NHMRC-approved guideline; current web status checked 2026-08-20 路 accessed 2026-08-20
    view source
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