Use of histopathology services by general practitioners: recent changes in referral practice

To determine the nature and magnitude of the histopathological workload generated by specimens received from general practitioners and to assess the trends in referral practice.

All material submitted by general practitioners to the Leicester district histopathology service from 1989 to January 1993 was identified from departmental records. All GP referrals from October to December 1992 were also analysed. Total numbers of referrals from all sources were used for comparison. Specimens were also analysed according to diagnostic categories.

There has been a progressive rise, both in the absolute number and the proportion of specimens relative to other surgical specimens submitted by GPs. Most are skin biopsy specimens. There were clear changes over the study period in the relative proportion of different types of lesions received, with a substantial increase in samples of benign naevi and papillomas. There was some evidence of a corresponding decrease in the number of these lesions submitted by hospital practitioners. The number of malignant skin tumours from GPs was small and the proportion had not increased over the study period.

Histopathological workload generated by GPs is increasing but it still represents a small proportion of the total. The major increase is in benign skin lesions.