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Updated: Dec 17, 2025

Establishment of a Clinic-based Biorepository
Published on: May 29, 2017
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.
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.
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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