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Skin cancers: recognition and referral

A Canadian clinical summary of skin cancers: recognition and referral, with source-attributed priorities and explicit jurisdiction boundaries.

JurisdictionCanada
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 Canada
This is an iatroX educational summary of named Canada sources, not an official guideline. It does not replace the complete source documents, local policy, specialist advice or clinical judgement. Ontario is used as an explicit Canadian implementation example, not as a national rule. Verify the equivalent pathway, formulary and escalation route in the patient鈥檚 province or territory.

Ontario source: bounded use

Skin Cancer Diagnosis, Treatment and Follow-Up Pathway Map supplies a Canadian implementation example for this summary. It must not be presented as the rule outside Ontario.
sources for this section:Ontario skin cancer pathway

Source-attributed clinical priorities

  • Examine suspicious lesions systematically and document evolution, morphology, symptoms, size and site.
  • Use dermoscopy where trained and arrange biopsy or referral according to suspected melanoma, keratinocyte cancer and local pathway.
  • Escalate rapidly changing pigmented lesions, destructive lesions, high-risk sites and immunocompromised patients.
  • Compare with previous photographs or lesion history because evolution is a key malignancy clue.
sources for this section:Ontario skin cancer pathway

Practical assessment and management workflow

1
Inspect the entire lesion and relevant skin and nodes and document size, color, border, ulceration and change.
2
Use dermoscopy when trained and photograph with scale and site identification.
3
Choose complete biopsy or direct specialist referral according to melanoma suspicion, site and local pathway.
4
Track pathology and ensure margin or staging follow-up is not lost between services.
sources for this section:Ontario skin cancer pathway

Safety, red flags and urgent escalation

  • A rapidly changing pigmented lesion, destructive ulcer or suspicious node needs expedited assessment.
  • Avoid superficial shave sampling when it would prevent reliable assessment of suspected melanoma depth.
  • Immunocompromised patients and high-risk anatomic sites need a lower referral threshold.
sources for this section:Ontario skin cancer pathway

Confirm the local pathway before acting

Ontario is used as an explicit Canadian implementation example, not as a national rule. Verify the equivalent pathway, formulary and escalation route in the patient鈥檚 province or territory.
sources for this section:Ontario skin cancer pathway

Source and implementation boundary

Read this educational summary with the linked source, current Canadian product information where medicines are involved, and the applicable provincial or territorial pathway. Local formularies, reporting duties, referral routes and service availability can differ.
sources for this section:Ontario skin cancer pathway

Source documents

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

  1. Ontario Health (Cancer Care Ontario)Skin Cancer Diagnosis, Treatment and Follow-Up Pathway MapVersion 2025.10 路 accessed 2026-08-20
    view source
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