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

Scott Kitchener1, Janani Pinidiyapathirage2, Keegan Hunter3

  • 1MBBS, MD, DrPH, FAFPHM, Professor of Rural Medicine, School of Medicine, Griffith University, Qld.

Abstract

Insights

General practitioners (GPs) play a crucial role in secondary skin cancer prevention, especially for rural Australians. Early detection through whole-body skin examinations by GPs improves outcomes for melanoma and keratinocyte skin cancers (KSCs).

Area of Science:

  • Dermatology
  • Oncology
  • General Practice

Background:

  • Secondary prevention of skin cancer via active screening is not universally recommended due to limited mortality reduction evidence.
  • Rural Australians face challenges accessing specialized skin cancer care, impacting health outcomes.
  • General practice settings are key for evaluating secondary skin cancer prevention strategies.

Purpose of the Study:

  • To evaluate the effectiveness of secondary skin cancer prevention within general practice.
  • To assess the role of general practitioners (GPs) in detecting melanoma and keratinocyte skin cancers (KSCs).

Main Methods:

  • A clinical audit was performed on 317 melanomas and 5463 KSCs.
  • The study examined the nature of consultations and the stage of cancer at diagnosis.

Main Results:

  • GPs identified smaller melanomas (≤1 mm) more frequently during planned whole-body skin examinations than patient-reported complaints.
  • Keratinocyte skin cancers (KSCs) were diagnosed as presenting complaints (49%), incidentally (21%), or during whole-body examinations (30%).
  • Half of all squamous cell carcinomas were detected at the intra-epidermal stage.

Conclusions:

  • Secondary skin cancer prevention by GPs offers significant value, particularly for rural populations.
  • Early detection of skin cancers in general practice improves patient outcomes.

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