Primary prevention of skin cancer in primary care settings - A scoping review

Abstract

Background: Skin cancer is highly preventable through primary prevention activities such as avoiding UV exposure during peak times and regular use of sun protection. General practitioners (GPs) and primary care nurses are often the first point of call for skin cancer concerns and are well placed to promote sustained primary prevention behaviours.

Aim: To review the evidence on skin cancer primary prevention activities in primary care settings, including the associated barriers and enablers to delivering skin cancer prevention.

Methods: We conducted a comprehensive search using a strategy aligned with the SPIDER tool for Qualitative and Mixed-Methods Evidence Synthesis in Embase, Medline, PsychInfo, Scopus, Cochrane Central and CINAHL, and relevant grey literature sources such as cancer and skin cancer peak bodies and primary care organisations. The literature was limited to publications from 2014 that included skin cancer primary prevention activities within primary care settings, for example involving GPs and primary care nurses, for studies or programs conducted in Australia and countries with comparable health systems. This work was funded by the Cancer Institute NSW.

Results: A total of 25 peer-reviewed journal articles and 28 grey literature resources were included in the review. We identified four key types of primary prevention activities: behavioural counselling; risk assessment and delivering risk-tailored information; new technologies for early detection with linked primary prevention information; and education and training programs for the primary care workforce. Several key enablers and barriers were identified; examples of enablers include pairing with early detection activities, easy-to-understand patient information, fitting with existing workflows and systems; examples of barriers include unclear requirements, lack of confidence in prevention counselling, competing demands, low priority, lack of time, and limited availability of GP services especially in regional and remote areas.

Conclusions: These findings highlight potential opportunities for enhancing skin cancer prevention activities in primary care.