Moles: Histological Testing

I beg to move,

That this House has considered histological testing of excised moles.

It is a great pleasure to serve under your chairship, Ms Jardine.

Many of those present may not yet be familiar with the name Zoe Panayi. If they are, it is likely to be because of my hon. Friend the Member for South Norfolk (Ben Goldsborough), who spoke about Zoe at Prime Minister’s questions two weeks ago. For Zoe’s family, the five years since her tragic death have meant that their daughter, sister, mother and friend has come to represent something far greater—a legacy that continues to grow and touch lives beyond their own. I welcome Charlie, Zoe’s brother, to Westminster Hall today.

Zoe was like so many other 26-year-olds. She was a devoted mother to her two boys, a loyal friend to many across the island and a young woman full of promise. Despite her age, Zoe made a remarkable impact on our community. She volunteered as a carer, and later trained to become a radiologist at St Mary’s hospital. That is what makes Zoe’s story so heartbreaking. While she was dedicating herself to caring for others, her own health concerns were repeatedly dismissed.

On the morning of Zoe’s eventual diagnosis, she woke up in pain, but brushed off her concerns, telling her mum that she had been teaching her boys how to do roly-polies—which many Members will know is, as an adult, no mean feat—and must have hurt herself that way. But that evening Zoe was in such excruciating pain that she was taken to hospital where, upon being tested by her boss at St Mary’s, she was told that her liver was full of cancer.

Doctors asked Zoe whether any moles on her body had been causing her concern. She then realised that the small mole on her back was the root of her cancer. Zoe died just 55 days after that diagnosis, and in those 55 days she had to try to explain to a five-year-old and a seven-year-old that mummy would soon not be coming home, and would instead become an angel. I do not bring that up purely to cause upset, but to emphasise Zoe’s outstanding bravery at such a young age in ensuring her boys were prepared for the unthinkable.

Zoe had not ignored her symptoms; she did everything right. She visited her GP on three separate occasions asking that her mole be tested, yet she was told that her pain was caused by the mole rubbing against her jeans, and that she was too young for it to be clinically concerning. On her third visit, Zoe was told that if it bothered her that much, she should get her mole removed cosmetically. Zoe even paid for her mole to be tested after removal at the beauticians, yet it never was.

There is no doubt that Zoe was failed by her GP, who sent her a letter of apology after learning of her diagnosis, and that Zoe was failed deeply by her beautician, who failed to recognise her cancer or even to send her mole for testing. Zoe’s concerns should never have been dismissed, she should never have been referred out of the NHS, and the mole, which was actually a melanoma, should never have been removed. I welcome the fact that the Minister has enacted Jess’s rule, meaning that on the third time of asking, Zoe’s concerns may have brought about a different outcome.

We are not here today because Zoe’s family want to cast blame; we are here because Zoe’s family want to make sure that what happened to their daughter, their sister and their mother will never have to happen to anyone else again. The safeguard we are asking for is simple: that all healthcare providers must test the lesions they remove. This extra check—a “Zoe check”—would prevent tragedies like Zoe’s from occurring.

Over the past months I have spoken with a range of doctors across the NHS and in the private sector, and reassuringly—although it is not mandated—what we are asking for is already standard practice in the NHS for GPs and dermatologists. To avoid that one in a 1,000 case, removed skintags, moles or blemishes, however harmless they look, are almost always sent for testing. NHS doctors order these tests as a matter of routine, and many good private dermatologists insist on including a biopsy before agreeing to treatment in the first place. The tests are relatively cheap, with lab fees around £100. To put that into perspective, the cost of Zoe’s cancer treatment could have funded over 650 biopsies.

Using state-of-the-art technology, we could go further. Trials are under way for handheld equipment that can test for melanoma by using artificial intelligence systems to analyse high-definition photographs of skin lesions. If those trials prove successful, the cost of Zoe’s treatment could have funded thousands of pre-treatment checks. The checks are cheap, immediate and, with proper training, could easily be deployed in beauty clinics and other non-medical environments. If we combine them with specific melanoma training for all professionals who encounter skin lesions, and encourage GPs and others to take up that training, that approach could significantly improve early detection and reduce the need for costly and often unsuccessful late-stage cancer interventions.

Cancer is not a place to cut corners. Although they are not mandatory, histology tests are already routine practice for benign moles and other lesions in both NHS and private dermatology alike. Zoe’s law would ensure that a similar safeguard is applied across the board, from NHS hospitals to private dermatologists and beauty clinics. That would demand more from the clinics that are currently the least regulated. But we should demand more, because this is about protecting the NHS, which will ultimately pick up the bill when those clinics fail, and it is about protecting families like Zoe’s from the grief of a tragic and unnecessary death.

I thank the Minister for her engagement, and I am genuinely encouraged by the seriousness with which her Department has adopted the issue. Zoe’s family has said that they feel they have got further than ever before over the past weeks, and that they feel listened to. I thank the Minister very much for that, but this can only be the start, and whatever form Zoe’s law eventually takes, we must not stop until we get there.

It is a pleasure to serve under your chairmanship, Ms Jardine. I congratulate my hon. Friends the Members for Isle of Wight West (Mr Quigley) and for South Norfolk (Ben Goldsborough) on securing this vital debate on the histological testing of excised moles. I am chair of the all-party parliamentary group for beauty and wellbeing, and this issue aligns closely with our current inquiry into ultraviolet safety. It sits right at the heart of the concerns that led to the launch of the inquiry earlier this year.

Unprotected UV exposure poses huge risks and is creating a greater volume of potentially malignant lesions. We know that it is the main driver of the formation of new moles and the malignant transformation of existing ones. As the number of cases escalates, so does the need for accurate and timely histological testing. The success of the entire melanoma pathway hinges on that final, non-negotiable diagnostic step. We must ensure that the NHS’s resources, training and standardisation for histological analysis are robust enough to manage the growing volume.

Figures from Cancer Research UK paint a worrying picture: nearly 18,000 new cases of melanoma are diagnosed each year in the UK, and that is projected to rise to nearly 27,000 by 2040. The pressure on pathology services to diagnose excised lesions correctly and rapidly is immense, and it is only going to rise. What is perhaps more tragic is that 86% of these cancers are preventable. If people were better able to protect themselves against UV radiation, we could slash the number of cases and ease the burden on our health services.

Our APPG inquiry into UV safety launched in May, and aims to take evidence from clinicians, academics, industry experts, media influencers and those with lived experience. Although we will not report until spring next year, we are already seeing patterns in the evidence we have received in oral sessions and through written submissions: calls for public awareness campaigns so that people are better educated on how to check their moles and seek medical intervention when needed; questions around the labelling of the sun protection factor and affordability of sun cream; and a widespread concern over the regulation and marketing of products that have known melanoma risk factors. I am sure the Minister will listen today and that she is acutely aware of the critical importance of this issue.

It is a pleasure to serve with you in the Chair, Ms Jardine. I congratulate the hon. Member for Isle of Wight West (Mr Quigley) on securing this important debate—I call him a friend, because we are working on quite a lot of issues together. He told the courageous story of Zoe, her family and their courageous campaign so beautifully, and made the case that if we detect cancers like this early, we save money across the board, because expensive hospital treatment will be avoided. The cost of detection and testing is a fraction of the cost of treatment.

Stories like Zoe’s are truly heartbreaking. We cannot change what happened to her, but we must learn from it to make sure it is never allowed to happen again. I entirely welcome the call to make it mandatory for all excised moles to be tested, even if they are removed for cosmetic reasons. Performing histological testing on removed moles will help us to diagnose more cancers and, of course, save lives. We will also probably find out more about the extent of cancers that we would not have linked to other severe cancers if we did not do that testing.

Currently, the British Association of Dermatologists recommends that all removed skin lesions be tested, even if they are taken off for purely cosmetic reasons, but there is currently no specific requirement for those tests, despite that advice. The tests are often carried out when moles are removed in a medical setting by the NHS, but we must ensure that private cosmetic clinics also follow the requirement for testing. The introduction of Zoe’s check will ensure that every mole is tested, thereby making sure that early signs of skin cancer are never missed or overlooked and that heartbreaking stories like Zoe’s are never repeated.

Early detection is paramount. Too many people are slipping through the cracks in the system and not being diagnosed until it is too late. Catching cancer early allows it to be tested faster, thereby giving treatments a greater chance of being done quickly and succeeding. We have campaigned across the House for the earlier detection of cancers. I also have a campaign to detect breast cancer early through a better screening programme for younger women, because cancer is on the rise throughout all ages—it is not just an illness of older people.

It is a pleasure to serve under your chairship, Ms Jardine. My speech today will come from a personal perspective, as well as my talking about Zoe Panayi’s life experience. I start with thanks, because this is a huge part of my own journey, as well as the journeys of everyone in this room. I thank the Backbench Business Committee for granting this debate.

I want to give my thanks to Zoe’s family for letting me meet them a couple of weeks ago. It was an honour, and I cannot say that strongly enough. I also thank my hon. Friend the Member for Isle of Wight West (Mr Quigley); I would never have known about Zoe’s journey, tragedy and her family’s loss without him reaching out to me and asking me to support and be involved in this vital campaign.

I need to thank those who are currently treating me for stage 2C malignant melanoma. A lot of people might be wondering—including those watching at home—“Is he getting his treatment at the Norfolk and Norwich?” Unfortunately not—so that I can carry on doing my job, which I am really determined to do—my treatment is currently being done at Charing Cross hospital in London. To lift the mask off, yesterday was my treatment day, and I went in for pembrolizumab immunotherapy. I thank those on the sixth floor in the oncology department —I will not name names, because sadly there are too many of them who have to shove a canula into me every three weeks, and I would be here forever listing their names.

I thank everyone in clinic 8 in the phlebotomy team who look after me. I thank my oncologist, who has gone above and beyond to hold my hand and make sure that I have the mental support and wellbeing that I need as well as the physical support. Those people have made a difference to my life. It reminds me of, “There but for the grace of God go I”, when we talk about Zoe’s life. The reason why I will keep referring to Zoe is because Zoe Panayi is a name that needs to be in Hansard as much as humanly possible. We lost her in tragic circumstances.

It is an honour to serve under your chairpersonship, Ms Jardine. I congratulate the hon. Members for South Norfolk (Ben Goldsborough) and for Isle of Wight West (Mr Quigley) on securing this debate. I wish the hon. Member for South Norfolk all the best in his treatment. I have to say, it was hugely brave of him and emotive to hear him talk about the journey he is going through at the moment, and to hear him paying such tributes to all the staff involved in his care. I also thank Zoe’s family for coming here today, because it cannot be easy to hear people talk about this disease after everything they have been through.

Many of us will know, some from personal experience, how frightening it can be to face a possible or actual cancer diagnosis. When words such as “biopsy” or “diagnostic tests” enter the conversation, that provokes deep concern, and yet those tests, as everyone has been reiterating, are absolutely vital. Early diagnosis is the single most important factor in improving survival rates. The sooner any type of cancer is identified, the sooner treatment can begin, and the more likely the outcome will be favourable. The tests are very important for people’s mental health, because sometimes the test is clear: a person knows that, and knows there is no need to worry unnecessarily.

In an ideal world, someone who notices a suspicious mole or mark would call their GP; be seen within two weeks, as set out in the National Institute for Health and Care Excellence guidelines; if necessary, a biopsy would be taken; and, if cancer was confirmed, treatment would begin within 62 days. In an ideal world, that treatment would be available to everyone, regardless of their postcode.

We know that is not the reality for everyone, either in Winchester or the rest of the country. We know GP access is a growing concern. In Winchester, I regularly hear from my constituents that they are waiting weeks for appointments, which means we are falling at the first hurdle. The second hurdle—treatment within 62 days—is just as worrying. In Winchester, in July 2025, only 73.6% of cancer treatments began within 62 days, well below the operational standard of 85%.

I wanted to be here at the beginning, but unfortunately I could not because I had other things to do in the Chamber. I declare an interest—like the hon. Member for South Norfolk (Ben Goldsborough), I am going to get one of mine done very shortly, but in Northern Ireland the wait list is 56 weeks. If it is red-flagged, it is five weeks. There is anxiety and stress for everyone—not for me, but for all the others—because it is not about me but everyone else. Does he agree that the NHS, wherever it may be in this great United Kingdom of Great Britain and Northern Ireland, needs to ensure that those who have melanoma and a biopsy get the urgency that is absolutely critical? The Minister is in her place—there is no better person to answer these questions than her—and I look forward very much to what she says. Does the hon. Member for Winchester (Dr Chambers) agree that a concerted campaign across this great United Kingdom of Great Britain and Northern Ireland to address those issues might be a way forward?

I totally agree with those comments.

I will finish by paying tribute to one of my friends from vet school, Polly Birch. She was diagnosed with a melanoma in 2016 and had it removed, but in 2017, a few months after giving birth to her baby girl, Ada, she discovered it was metastatic, and she passed away. Her final post on social media was beautiful and moving. A couple of days before she passed away, she said:

“Appreciate the people around you, adventure with them, buy less stuff and go out and experience the world…and look after the bees.”

Finally, and perhaps most poignantly, I will quote Mary Schmich:

“If I could offer you only one tip for the future, sunscreen would be it.”

It is a pleasure to serve under your chairmanship, Ms Jardine. I congratulate the hon. Members for Isle of Wight West (Mr Quigley) and for South Norfolk (Ben Goldsborough) on securing this debate and on their very emotional speeches. I thank the hon. Member for South Norfolk for his bravery in talking about his own care. I commend Zoe’s family for their bravery and for their work to turn a family tragedy into something positive for other people, which is fantastic.

Melanoma is the deadliest form of skin cancer and, frighteningly, the fifth most common cancer in the United Kingdom: almost 20,000 people are diagnosed each year. It usually starts in skin or a mole that is over-exposed to ultraviolet radiation, and then it spreads to vital organs such as the lungs or the liver.

One of the challenges is that melanomas can be difficult to identify. I am a paediatrician, not a dermatologist, but I remember looking at pictures of melanomas and moles in medical school, and in lots of cases I struggled to see the difference that the lecturer was pointing out. They can be brown, red or pink; small or large; flat or raised. Unlike other cancers, which tend to progress as they grow larger, melanomas can be lethal even when they are very small, which means that there is no time to lose in having the diagnosis.

All suspicious moles removed by the NHS should be tested, but those judged benign or removed in cosmetic or beauty settings are not necessarily tested, as has been said. There is therefore the risk that, if that judgment was wrong, the cancer can go undetected and it can have tragic consequences. I want to ask the Minister what steps she is taking to strengthen the regulations in the aesthetics and beauty sector, in particular, and in the private medical sector. What will be done about lasering moles in a way that prevents identification of a melanocytic lesion?

We know that AI can help. There are now computer systems that look at moles in photographs and are reasonably reliable at discerning whether something is malignant. That can be done in conjunction with doctors and histology as an additional layer to ensure there are no mistakes. Will the Minister update the House on what she is doing with AI? One of the big shifts that the Government have talked about is digital, and that is one of the options available to them.

It is a pleasure to serve under your chairship, Ms Jardine. I thank my hon. Friend the Member for Isle of Wight West (Mr Quigley) for this important debate and all hon. Members who have contributed. I thank my hon. Friend the Member for Neath and Swansea East (Carolyn Harris) for raising the report by the APPG for beauty and wellbeing; I look forward to considering it in the new year. I thank the shadow Minister, the hon. Member for Sleaford and North Hykeham (Dr Johnson), for raising the issues of sun damage and sunbeds. I am exploring options with respect to those issues and will report to Parliament as necessary.

Let me say how sorry I was to hear about the heartbreaking circumstances of Zoe’s story. My sympathies are with her family. I was honoured to meet them and hear their story at first hand earlier this month, and I am glad to see some of them in the Public Gallery today. I commend their campaigning in Zoe’s name.

I would also like to take a moment to acknowledge the personal experience of my hon. Friend the Member for South Norfolk (Ben Goldsborough) with stage 2C malignant melanoma. I commend his courageous efforts to share Zoe’s story alongside his own. From awareness-raising, better regulation and improved diagnostics, all the way through to fundamentally reforming the NHS, we will seize every opportunity to learn from preventable and unnecessary tragedies like Zoe’s, to help to save the lives of others.

The last time that I checked, the petition for Zoe’s law had received almost 40,000 signatures and many more people will have seen Zoe’s story in the news. Just a couple of weeks ago, my right hon. Friend the Prime Minister paid tribute to Zoe’s family for their work. I commend all those who have raised awareness of skin cancers through Zoe’s story, because the faster and earlier that people are diagnosed with skin cancer, the faster they can begin treatment and the more effective that treatment can be.

The Government are taking steps to promote awareness of signs and symptoms through the NHS’s “Help Us Help You” campaigns, which aim to increase knowledge of cancer symptoms and encourage body awareness, helping people to spot symptoms earlier. Let me also take this opportunity to further promote the NHS’s clear and accessible information about how to check moles. That guidance is available to everyone on the NHS website and makes it easier for people to recognise when they should seek medical advice.

I called for teledermatology on another occasion because it absolutely works. Does the Minister have any figures on how many GPs are using that as the basis of their diagnosis? My husband recently went to our GP and he was still referred to the hospital, so I am not confident that a lot of GPs are making use of it.

The majority of those services are provided through community diagnostic centres. I do not have any figures to hand but I am more than happy to write to the hon. Member with whatever figures we have available.

Within those services, we have recently begun testing AI-based platforms to triage patients following referral from primary care. I have seen at first hand how useful AI can be in flagging potentially risky images so that the consultant can prioritise and explore them. I know that my hon. Friend the Member for South Norfolk takes a keen interest in those developments. Further roll-out of AI in the NHS for this purpose will be subject to assessments of clinical effectiveness and cost-effectiveness, which are ongoing, but I can say from first-hand experience that it offers a very exciting opportunity and falls distinctly within our ambition for the shift from analogue to digital.

Although immediate action is essential, we recognise that bold reform is needed if we are to rise to the growing challenge that cancers of all types present. We will publish the national cancer plan in the new year to reduce the number of lives lost to cancer over the next 10 years. We have received over 11,000 responses to our call for evidence from individuals, professionals and organisations, and we are reviewing the submissions from skin cancer partners. Publication has been delayed by about six weeks to ensure that all the responses are properly considered in the plan. Our expansive engagement will allow the national cancer plan to have patients at its heart. The plan will cover the entirety of the cancer pathway, from referral and diagnosis to treatment and ongoing care.

I thank my hon. Friend the Member for Isle of Wight West again for bringing this important matter to the House, and I thank all Members who have contributed. I am pleased to assure them that we are undertaking immediate actions to learn from Zoe’s story. Combined with our bold reforms to create a health service that is fit for the future, we will reduce the number of lives lost to the biggest killers, including skin cancer.

I thank the Minister for her remarks. I do not think anyone would question her passion and commitment to this cause. I thank her for previously sharing her own diagnosis. It is important that people understand that cancer can affect anybody. I thank my hon. Friend the Member for Neath and Swansea East (Carolyn Harris) and the hon. Member for Bath (Wera Hobhouse)—and it would not be a debate without the hon. Member for Strangford (Jim Shannon) making some contribution.

Zoe Panayi did everything right. She sought help and she trusted the system, and yet the safeguards that should have protected her did not. That is why this debate matters. Zoe’s law is not about blame; it is about prevention. It is about making sure that every mole removed is tested. That is a small step with a profound impact—one that could save lives, reduce the burden on the NHS and spare families unimaginable grief. The cost is not preventable: the technology exists and the reason is clear —cancer is not a place to cut corners.

I know that all the contributions we have heard today mean such a lot to Zoe’s family, her brother Charlie, and mum Eileen watching at home. We must not forget the human tragedy behind this story: the children who have lost a mother, the family who have lost a sister and a daughter, and the community who have lost a friend. That is why Zoe’s law is so important. I urge the Department to continue working with Zoe’s family, with me and with my hon. Friend the Member for South Norfolk (Ben Goldsborough), who has shared so much of his own journey, making such a difference. I thank him for his commitment to this cause, and for the support and extremely generous amount of time that he has given me. We need to make this safeguard a reality so that what happened to Zoe is never repeated.

That this House has considered histological testing of excised moles.