Site specific - Skin

All skin cancers diagnosed from January 2018 should be staged using UICC TNM v8, and the stage fields (which are included in the core data set), should be used where applicable:

• for Melanomas the full Core and Site Specific data sets must be submitted
• for SCCs and BCCs which require MDT discussion, the full Core and Site Specific data sets must be submitted
• for other non-melanoma* cases which require MDT discussion, only the Core data set should be submitted
• where stage is applicable for these cases (for example Merkel Cell tumours and Adnexal carcinomas) please use the CORE Staging fields, using UICC TNM 8
• for all skin cancers that do not require MDT discussion, the minimum requirement is for the pathology report to be submitted
• for skin cancers that do require MDT discussion it is acceptable for the pathology stage to be taken to be the integrated stage when submitting COSD
• providers are encouraged to submit more complete data sets if possible

Grade of Differentiation is not applicable for skin cancers other than SCC and therefore ‘Grade of Differentiation (at Diagnosis)’ is not applicable for Melanoma, BCCs or Merkel Cell tumours.

Non-melanoma skin cancers include:

• BCC
• SCC
• Merkel Cell tumours
• Adnexal (primary malignant adnexal carcinomas of eccrine, apocrine, follicular and sebaceous subtypes)
• other NMSC

ICD-10 codes

Note:

• please refer to Appendix A and B for site specific registerable ICD codes for skin cancer patients

Malignant neoplasm of the anus should be coded as:

• margin (C43.5, C44.5)
• skin (C43.5, C44.5)
• perianal skin (C43.5, C44.5)

Data within this section would be expected to be available at the MDT, where the care plan was agreed. This is a child of 'Core – Cancer Care Plan'.

May be up to one occurrence per Core - Cancer Care Plan (0..1)

Immunosuppressed Status

This is a new data item for v10. Record the patient's immunosuppressed status.

Examples of immune suppression includes:

• organ transplant recipients
• immunosuppressive medication
• haematological malignancy
• HIV/hepatitis B or C

This section includes surgery details for Basal Cell Carcinoma, Squamous Cell Carcinoma, and Malignant Melanoma This is a child of ‘CORE – Treatment’, and will mandate:

• the date the treatment started
• the treatment modality
• the organisation that provided the treatment

May be up to one occurrence per CORE – Treatment – Surgery (0..1)

Grade of Clinician/Surgeon Operating

This is the level of training reached of the actual operating Clinician or Surgeon, and not necessarily the responsible Clinician.

Notes:

• ‘SAS - Specialty and Associate Specialist’ is a new selection from v10
• ‘SI - GP with an Extended Role (GPwER)’ national code definition has been updated to meet new Data Dictionary terminology
• OO has been retired and replaced with 98, on the advice of the NHS Data Model and Dictionary Service

Member of Specialist MDT

Is the actual operating Clinician or Surgeon a member of the Specialist MDT?