Photographs of non-melanoma skin tumours submitted by patients improve preoperative triage

The incidence of non-melanoma skin cancer is rapidly increasing, along with the demand for surgical treatments. Most lesions can be treated with same-day examination and simple surgery, while more complex cases require advanced procedures and a separate pre-surgical visit. However, referral letters often fail to convey case complexity accurately, resulting in unnecessary hospital surgical planning visits for cases that ultimately require only simple procedures. Efficient triaging is essential to direct patients to the appropriate treatment pathway. This study evaluates whether patient-submitted photographs can improve the efficiency and accuracy of surgical planning for non-melanoma skin cancer in a prospective cohort study. Patients were invited to submit photographs and complete a simple survey using the mobile application 'Mit Sygehus'. Data were extracted from electronic medical records and used to analyze triage patterns during a six-month baseline period, response rates to the study invitation over an 18-month study period, and differences between responders and non-responders using appropriate statistical tests. In the baseline group, 116 patients were triaged for surgical planning but ultimately underwent minor procedures without reconstructive surgery, suggesting they could have benefited from photo-assisted triage. In the study group, 201 patients were eligible for photo-assisted triage, as it was not clear from the referral letters which treatment would be appropiate. We had 95 patients responding to the invitation with 50 of these triaged directly to surgical treatment. Responders had shorter wait times to treatment compared to non-responders. In conclusion, patient involvement in telemedicine improves pre-surgical triage, reducing hospital visits and time to surgery for patients with non-melanoma skin cancer.