Management of primary superficial basal cell carcinoma

Superficial basal cell carcinoma (SBCC) is a skin cancer commonly treated by general practitioners. Little is known about how GPs choose from the available treatment options.

A cross sectional survey was conducted by self administered questionnaire.

Of 257 GPs surveyed, 107 responded (adjusted response rate 59%). Sixty-three percent reported treating more than two SBCC per month, managing 90% themselves, mostly by surgery (57%), and imiquimod 5% cream (19%). Forty percent of SBCC patients were referred to a plastic surgeon, and 26% (IQR 0-50%) to a general surgeon. Contraindications to surgery included lesion site (14%), and size (12%). Sixty-two percent of GPs reported never using curettage and cautery, and 23% never cryotherapy. If the cost of imiquimod 5% cream were to be subsidised through the Pharmaceutical Benefits Scheme, GPs predicted its use for SBCC would increase from 34 to 58% (p>0.001).

General practitioners manage most lesions themselves and refer appropriately. Areas of educational need were identified with respect to management of inadequately treated or recurrent lesions.