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Bridging the Gap: Implementing the 2024 National Cancer Control Programme (NCCP) Melanoma Imaging Guidelines in
Abstract:
Malignant Melanoma is the fourth most common cancer in Ireland, known for rapid progression and metastasis. Targeted immunotherapy has significantly improved 5-year survival. In May 2024, the National Cancer Control Programme issued guidelines for radiological staging and surveillance, helping clinicians in determining the appropriate radiological modality and timeline for staging and surveillance. This audit revealed gaps in follow-up imaging due to organizational constraints and health service pressures. Compliance with staging imaging was high at 92% (11/12), improving to 100% (12/12) following re-audit. In contrast, compliance with surveillance imaging was lower, with 55% (6/11) for PET-CT and 27% (3/11) for MRI/CT brain, improving to 87.5% (7/8) and 50% (4/8), respectively, in the second cycle. Continued audit and multidisciplinary education are vital for consistent, guideline-based melanoma follow-up.
Insights
Malignant melanoma follow-up imaging in Ireland shows improved staging compliance after audits. However, surveillance imaging compliance remains a challenge, highlighting the need for ongoing education and audits to ensure guideline adherence.
Area of Science:
- Oncology
- Radiology
- Public Health
Background:
- Malignant melanoma is a significant health concern in Ireland, characterized by rapid progression and metastasis.
- Advances in targeted immunotherapy have improved survival rates for melanoma patients.
- New national guidelines (May 2024) aim to standardize radiological staging and surveillance for melanoma.
Purpose of the Study:
- To audit compliance with the National Cancer Control Programme's guidelines for radiological staging and surveillance in malignant melanoma.
- To identify gaps in follow-up imaging protocols.
- To assess the impact of re-audits on compliance rates.
Main Methods:
- Retrospective audit of radiological staging and surveillance practices for malignant melanoma patients.
- Data collection on compliance with recommended imaging modalities and timelines.
- Re-audit conducted to evaluate improvements following initial findings.
Main Results:
- Initial compliance with staging imaging was high (92%), improving to 100% post-re-audit.
- Initial compliance with surveillance imaging was lower: PET-CT at 55% and MRI/CT brain at 27%.
- Surveillance compliance improved in the second cycle to 87.5% for PET-CT and 50% for MRI/CT brain.
Conclusions:
- While staging compliance is high, adherence to surveillance imaging guidelines for malignant melanoma requires improvement.
- Organizational constraints and health service pressures contribute to gaps in follow-up imaging.
- Continuous auditing and multidisciplinary education are crucial for consistent, guideline-based melanoma patient care.
