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当前和未来全科医生在皮肤癌护理中的作用:对 268 名全科医生的评估。

The current and future role of general practitioners in skin cancer care: an assessment of 268 general practitioners.

机构信息

Department of Dermatology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, the Netherlands.

出版信息

Br J Dermatol. 2014 Jun;170(6):1366-8. doi: 10.1111/bjd.12935.

Abstract

BACKGROUND

Given the increase in skin cancer (SC) it seems inevitable that general practitioners (GPs) will play a larger role in SC care in the near future.

OBJECTIVES

To obtain insights into the opinion of GPs with respect to their role in SC care, and their SC knowledge and skills.

METHODS

A self-administered questionnaire was sent to GPs in the region of Nijmegen, the Netherlands.

RESULTS

In total 268 GPs (49%) responded. An overwhelming majority were willing to extend their role in SC care. Furthermore, we noted the following results: (i) > 50% of GPs requested additional SC knowledge; (ii) GPs often treat actinic keratosis (AK) themselves, primarily with cryotherapy; (iii) > 50% would treat (low-risk) basal cell carcinoma (BCC) after additional training; (iv) only a few GPs are familiar with BCC guidelines; (v) the majority of patients with high-risk SC are referred to dermatologists; (vi) only a few GPs perform total body inspection and palpation of lymph nodes; and (vii) a large number of GPs inform their patients on risk factors in SC development.

CONCLUSIONS

Most GPs are willing to extend their role in SC care; however, more training is requested and the usage of guidelines should be encouraged. Those willing to extend their role should focus on improving their clinical diagnosis of skin tumours, treatment of low-risk skin (pre)malignancies, including field-directed treatment of AK and noninvasive treatment of BCC, and on prevention.

摘要

背景

鉴于皮肤癌(SC)的增加,全科医生(GP)在不久的将来在 SC 护理中发挥更大作用似乎是不可避免的。

目的

了解全科医生对其在 SC 护理中的角色的看法,以及他们的 SC 知识和技能。

方法

向荷兰奈梅亨地区的全科医生发送了一份自我管理问卷。

结果

共有 268 名全科医生(49%)做出了回应。绝大多数人愿意扩大他们在 SC 护理中的角色。此外,我们还注意到以下结果:(i)> 50%的全科医生需要额外的 SC 知识;(ii)GP 经常自行治疗光化性角化病(AK),主要使用冷冻疗法;(iii)> 50%的人将在接受额外培训后治疗(低风险)基底细胞癌(BCC);(iv)只有少数 GP 熟悉 BCC 指南;(v)大多数高危 SC 患者都被转诊给皮肤科医生;(vi)只有少数 GP 进行全身检查和淋巴结触诊;(vii)大多数 GP 告知患者 SC 发展的危险因素。

结论

大多数全科医生愿意扩大他们在 SC 护理中的作用;然而,需要更多的培训,并应鼓励使用指南。那些愿意扩大其作用的人应专注于提高他们对皮肤肿瘤的临床诊断、皮肤(前)恶性肿瘤的低风险治疗,包括 AK 的定向治疗和 BCC 的非侵入性治疗,以及预防。

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