Barriers to Early Melanoma Diagnosis in Ireland
Written by Michelle Lonergan, Cancer Awareness Nurse at the Irish Cancer Society
Source: Irish Pharmacy News, May 2026, pages 22.
The incidence of melanoma almost trebled between 1994 and 2017 in Ireland and is expected to increase by 172 per cent between 2015 and 2045, potentially giving rise to 3,078 new cases of melanoma annually. Melanoma disproportionately affects younger age groups, with one-in-three cases occurring in people under 50 years of age, according to the National Cancer Registry of Ireland.
We know the early detection of melanoma is crucial to increase the likelihood of effective treatment and cure. The five-year survival rate for people diagnosed with stage one melanoma in Ireland is 100 per cent. If melanoma isn’t detected until it reaches stage four, the five-year survival rate drops to 41 per cent.
There are some signs that we encourage people to pay attention to, and to raise with their GP to aid in the early detection of melanoma. We advise people to see their GP if they notice any new or changing pigmented lesion/dark spot on the skin; a long-standing pigmented lesion on the skin which is changing progressively in shape, size or colour regardless of age; a new pigmented line in a nail, especially where there is associated damage to the nail; or a lesion growing under a nail.
It’s also important for them to go their GP if they develop a pigmented lesion which has changed in appearance, or which is persistently itching or bleeding; an ‘ugly duckling’ pigmented lesion, which is one that looks different to all the other pigmented lesions that person has, and we also encourage familiarity with the ABCDE lesion system as this can help to determine whether a mole or skin lesion is suspicious for melanoma.
Ideally patients will be able to identify signs of melanoma, they will be seen quickly by their GP and, if their GP deems it necessary, they will receive a referral to a dermatologist. But we know things don’t always go seamlessly and that some people do face barriers when it comes to factors around getting a melanoma diagnosis.
One of the barriers which we actively try to address in our Skin Cancer Awareness Campaign, which kicked off this month and will run throughout the summer, is a lack of awareness around the signs of melanoma. And for some people who do know the signs and symptoms, they can have a delayed presentation to their GP due to fear, as they hope the skin change that they’ve noticed will go away on its own.
Lower levels of health literacy can mean patients present to their GP at a later stage when the melanoma could have progressed, and a lack of awareness of referral pathways can pose another barrier.
It is essential that healthcare professionals and patients can recognise the early signs of melanoma. Your GP is your first port of call. If a GP suspects that a patient has melanoma skin cancer, they can refer them to a pigmented lesion clinic (PLC) or to a dermatology or plastic surgery service so their skin change can be investigated, and it can be determined if it is, or is not, melanoma.
We know that securing access to get a mole or skin change assessed can be a barrier for some, with some people not being registered with a GP at all or having to wait longer than they would like to, to see a GP. The cost of a GP appointment can also be a barrier.
When it comes to getting a dermatologist to check a skin change or mole, we know that waiting times can be several months in some cases in the public system. According to HIQA, Irish dermatology services are “under significant pressure”, with more than 60,000 patients waiting for an appointment as of June 2025. Some people are waiting up to three years for a routine appointment.
HIQA has warned about the potential health risks to delays in accessing specialist dermatology services, such as reduced survival for cancers diagnosed at later stages and increased physical and psychological burden for patients.
Distance from a pigmented lesion clinic can be a potential challenge. A 2019 study by the Department of Dermatology, South Infirmary Victoria University Hospital (SIVUH), Cork and the Department of Histopathology at University Hospital Kerry (UHK) found that cases of melanoma diagnosed locally in UHK presented at an advanced stage compared to the national average.
The study’s authors noted that they suspected that the lack of access to a local pigmented lesion clinic in Kerry and long distances to travel to the SIVUH pigmented lesion clinic were barriers to melanoma diagnosis for the Kerry-based patients who were part of the study, particularly those who were elderly or disadvantaged.
Within the context of barriers to the detection of melanoma, it’s important to note that there are still opportunities for the early detection of melanoma – meaning more effective treatment and an increased likelihood of cure.
We aim to improve the early detection of melanoma through our Skin Cancer Awareness Campaign that encourages self-checking, and by empowering people with the knowledge and tools to seek help and to know the signs and symptoms of melanoma. We know that this can make a difference and can lead to better patient outcomes.
