ACCEPT:

• If the donor had a non- metastasised basal cell carcinoma (rodent ulcer) and local treatment is completed and all wounds are healed
• If the donor had a basal cell carcinoma (rodent ulcer) and systemic medical treatment was required and has been completed at least 24 months previously
• If the donor has a non-haematological (non-clonal) premalignant condition (e.g. Barrett’s oesophagus or polyposis coli) that is being regularly monitored
• If the donor has a non-haematological (non-clonal) premalignant condition that has been cured and the donor is discharged from follow-up
• If the donor has been cured of a carcinoma in situ (CIS) and discharged from follow-up (even if the donor received radiotherapy as part of the treatment). Donors who have been returned to routine screening following treatment for cervical CIS can be accepted. (e.g. of CIS include cervical or vulval CIS, ductal CIS of the breast (DCIS), prostatic intraepithelial neoplasia (PIN) and Bowen’s disease)
• A donor who has a high risk of cancer due to family history or following genetic tests, even if he/she had prophylactic surgery and is having routine check-ups. (e.g. prophylactic bilateral mastectomy because of a high risk of cancer due to a family history, following genetic tests BRAC1 or BRAC2

 DEFER:

• If the donor is prescribed prophylactic Tamoxifen until 6 months after cessation of treatment
• If the donor is under investigation for any other malignancy/cancer, until investigations are complete and the results are available

 REFER:

• If the donor has had a diagnosis of melanoma in situ (including Lentigo Maligna)

 PERMANENTLY EXCLUDE:

• If the donor was ever diagnosed with a malignancy (as outlined above) even if the donor has completed all therapy and is now fully recovered / considered to be cured
• If the donor was ever diagnosed with leukaemia or lymphoma even if they have completed all therapy and is now fully recovered
• If the donor was diagnosed with a clonal haematological disorder, e.g. primary polycythaemia (rubra vera), essential thrombocythaemia or monoclonal gammopathy of unknown significance(MGUS). Examples of CIS include cervical or vulval CIS, ductal CIS of the breast (DCIS), prostatic intraepithelial neoplasia (PIN) and Bowen’s disease

ADDITIONAL INFORMATION

Efudix (Fluorouracil ) is an anti-metabolite, i.e. a form of chemotherapy, used to treat skin cancer. If the product is being used to treat sun spots, defer for 6 months post treatment

Directive 2004/33/EC has legislative requirement that prospective donors with a malignant disease, except in situ cancer with complete recovery, are permanently excluded. Many malignancies can spread through the blood stream by invading surrounding tissues. Viruses that can be spread by blood and tissue donation can also cause some malignancies

Many malignancies can spread through the blood stream by invading surrounding tissues. Viruses that can be spread by blood and tissue donation can also cause some malignancies. For these reasons it is considered safer not to accept blood from people who have had a malignancy. However, basal cell carcinoma (rodent ulcer) does not spread through the blood, therefore people who have had successful treatment may donate (even if the treatment was systemic). Premalignant conditions are very common, particularly in older donors. Regular monitoring should prevent donors with invasive malignancy from being accepted. However, clonal blood disorders are treated in the same way as malignancy, as they originate from the proliferation of a single cell, and can become malignant. The term carcinoma in situ (CIS) refers to a group of abnormal cells which have not invaded deeper tissue or spread to another part of the body. Donors who have been cured and discharged from follow up may donate. For cervical CIS, donors can be accepted if treatment is complete. It is not necessary to wait for a normal smear result before donating. Regular screening smears are not defined as follow up. Melanoma in situ which has been cured by excision is not associated with a risk of metastasis. Patients with a confirmed diagnosis of melanoma in situ (i.e. Breslow thickness of 0 and no regression) do not require on-going follow up beyond the initial post-operative appointment. Lentigo Maligna is a common skin condition of the elderly that is found on the head and neck. It is considered to be a form of melanoma in situ. It should be distinguished from Lentigo Maligna Melanoma which is a true malignant melanoma