A cross-sectional study of skin cancer secondary prevention in rural general practice

Abstract

BACKGROUND AND OBJECTIVES: As a result of the lack of evidence of reduction in mortality, secondary prevention of melanoma and keratinocyte skin cancers (KSCs) with active screening is not recommended except for individuals at high risk. Limited access to medical professionals for diagnosis and specialised treatment of skin cancers are related to poorer health outcomes for Australians living in rural areas. The aim of this study was to evaluate the secondary prevention of skin cancer in general practice. METHOD: A clinical audit of 317 melanomas and 5463 KSCs was conducted, examining the nature of consultation and stage of cancer at diagnosis. RESULTS: It was more common for an uncomplicated melanoma ≤1 mm in size to be identified by a general practitioner (GP) during a planned whole-body skin examination than to be the presenting complaint found by the patient (χ2 = 4.2, P <0.05). Half (49%) of KSCs found were the presenting complaint, with 21% an incidental diagnosis during another presentation and 30% found during whole-body skin examinations. Half of all squamous cell carcinomas found were at the intra-epidermal stage. DISCUSSION: Secondary prevention of skin cancer by GPs is a value proposition for rural populations.