First Australian study reveals full extent of skin cancer care among GPs

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According to a new study, older, male and living in remote or deprived areas, this is the average profile of an Australian patient who visits their GP for skin cancer-related concerns.


The cross-sectional survey, published in BMJ openis the first study to measure all skin cancer-related conditions treated in general practice in Australia.


Participants were patients aged 15 or older who had a skin cancer-related condition treated by general practitioners in the Bettering the Evaluation And Care of Health (BEACH) study between April 2000 and March 2016.


During this period, 15,678 general practitioners recorded 1,370,826 patient consultations, whose skin cancer-related conditions were treated 65,411 times, a rate of 47.72 per 1,000 consultations. Skin cancer-related conditions accounted for 3% of all issues treated.


Dr. Jeremy Hudson, Chair of RACGP Special Interest Dermatology, said newsGP he is not surprised by these discoveries.


“Australia is internationally recognized as having the ‘gold standard’ for skin cancer screening and detection, and the majority of this is led by qualified GPs,” he said.


“We have the highest disease burden skin cancer worldwide, and general practitioners remain a proven means of screening and reliable, cost-effective and accessible care.


“There has also been an increasing visibility of skin cancer GPs to the general public. The number of skin cancers is expected to rise dramatically by 2030 with an aging Generation X, and it is nationally recognized that GPs will bear the majority of this clinical responsibility.


The study shows that rates of skin cancer-related conditions increased over time and that rates of treatment varied widely across patient subgroups, with overall rates being higher high for patients who are older, male and live in remote or more disadvantaged areas. .


The “general practice clinical activity encounter sample” indicates that a wide range of skin cancer-related conditions are cared for, with the highest to lowest frequency being:

• solar keratosis
• keratinocyte cancer
• other skin lesion
• nevus
• skin examination
• benign skin tumor
• melanoma.

The type of consultation also varied by age group, with young adults more likely to be seen in general practice for a mole or skin examination, whereas for older age groups they were more often seen for established skin cancers or their early precursors in the sun. damaged skin.

According to the study authors, their findings demonstrate “the spectrum and burden” of skin cancer-related conditions managed in general practice, which they hope can further guide education, policy and practice. interventions to optimize the prevention and management of skin cancer.

“Skin cancer-related conditions come in a wide range and each case is different,” said the paper’s lead author, Professor Anne Cust.

“But our study gives doctors and policy makers a better understanding of who is affected by these skin cancer-related conditions, where they are treated, and where we can direct resources and education programs.

“It is essential that we have the right resources where they are needed most, especially in regional and rural areas where the incidence of skin cancer is very high and access to specialist care is more limited.”

Although Dr Hudson agreed, he said GPs should first be individually assessed for their knowledge, skills and ability to perform appropriate skin cancer management roles.

‘General practitioners in Australia practice across a wide range of interests, abilities and geographical locations,’ he said.

“All education and intervention must first address a basic clinical standard for all GPs to perform a comprehensive skin examination with a dermatoscope.

“The second aspect must be the recognition and support of individual GPs in developing their training and providing resources.

“All leading bodies currently recognize that GPs play a vital role in the management of skin cancer, but this must translate into increased support for GPs who are doing a great job but are short on time, clinically overwhelmed and perform practices on the smell of an oily. cloth.’

The RACGP offers a Primary Care Dermatology Certificate for general practitioners and doctors in training.

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