Excising basal cell carcinomas: comparing the performance of general practitioners, hospital skin specialists and other hospital specialists

Abstract

GPs compare unfavourably with skin specialists in diagnosing and excising BCCs. The performance of nonspecialized GPs does not appear to differ markedly from that of GPwSI. There is considerable room to optimize current GP performance, particularly with lesions of the head and neck, and it may be that novel approaches to GP training are required to achieve this. Structured request forms may improve the quality of clinical information provided when skin biopsies are submitted for pathological examination.

Differences in Rate of Complete Excision of Basal Cell Carcinoma by Dermatologists, Plastic Surgeons and General Practitioners: A Large Cross-Sectional Study

“…Previous studies found similar proportions of complete BCC excisions; however, these studies lack a sample size calculation, subgroup analyses per tumor site and histological subtype, and logistic regressions [8][9][10][11]. Dermatologists probably excise BCC more often complete than GPs and plastic surgeons because dermatologists are specifically trained in BCC care during their 5 years of specialization, and dermatologists are more experienced in BCC care due to the high case load in their daily practice.…”

Safety of community-based minor surgery performed by GPs: an audit in different settings

“…These concerns have been echoed in research that found that GPs compare unfavourably with skin specialists in diagnosing and excising basal cell carcinomas (BCCs), the commonest malignancy excised in primary care; whereas non-specialised GPs perform no worse than GPs with a special interest (GPwSI). 2 However, the same authors found that GPs performed as well, if not better, than specialists in excising squamous cell carcinomas (SCC); whereas, again, practicebased GPs performed as well as GPwSIs. 3 Further research by the same authors showed that melanoma excisions by GPs appeared to be of similar quality to those undertaken by specialists; there was no difference demonstrated between frequent and infrequent GP surgeons.…”

A regional programme to improve skin cancer management

“…Standards are usually not monitored except by audit of individual doctors, with training generally being informal 'peer to peer' learning, with occasional continuing medical education activities. 2,3 and other countries [4][5][6][7] have shown that skin specialists diagnose and excise skin cancers better than GPs. GPs may unnecessarily remove benign lesions or, because of cost barriers for some patients, refer minor lesions to hospital clinics, placing a high demand on these services.…”