Service implications of the revised 2022 National Institute for Health and Care Excellence (NICE) follow-up guidelines for stage IA–IIC melanoma.

Background: The 2022 National Institute for Health and Care Excellence melanoma guideline update made significant changes to follow-up. The aim of this study was to assess the impact these changes will have on a national melanoma cohort over a 5-year follow-up interval. Methods: Anonymized, individual-level, population-scale, linkable primary and secondary care National Health Service data for an 18-year interval (2000–2018) in Wales, UK were analysed. These data were used to predict the number of patients over a 10-year interval (2020–2030) that would be diagnosed with melanoma. Follow-up schedules for the 2015 and 2022 National Institute for Health and Care Excellence melanoma guidelines were then used to calculate the number of clinician-led appointments, the number of radiological investigations, and the total healthcare cost between 2025 and 2030, corresponding to a 5-year patient follow-up interval, for those with stage IA–IIC melanoma. Results: Between 2025 and 2030 it is predicted that implementation of the 2022 guidelines would lead to 21 122 (range 19 194–23 083) fewer clinician-led appointments for patients with stage IA–IIC melanoma. However, there would be a significant increase in the number of radiological investigations (7812; range 7444–8189). These changes would lead to a €2.74 million (€1.87 million–€3.61 million) reduction in the total cost of follow-up over the interval 2025–2030. Conclusion: Melanoma follow-up guideline changes will result in a substantial reduction in the number of clinical follow-up appointments, but a significant additional burden to radiological services. The overall cost of follow-up at a national level will be reduced. Changes to the National Institute for Health and Care Excellence melanoma follow-up guidelines in 2022 will result in approximately 20 000 fewer clinician-led appointments over a 5-year interval in Wales. Despite the increase in radiology requirements, there will be a €2.74 million reduction in healthcare cost. [ABSTRACT FROM AUTHOR]