University of Edinburgh, Edinburgh Medical School, Edinburgh, UK.
Department of Dermatology, Royal Infirmary of Edinburgh, Edinburgh, UK.
Clin Exp Dermatol. 2018 Jun;43(4):441-444. doi: 10.1111/ced.13360. Epub 2018 Jan 12.
Skin cancer incidence rates are rising in the UK, yet many areas are experiencing a shortage of dermatologists. We sought to compare skin cancer excision rates between general practice (GP) surgeons to identify factors associated with good practice, through a retrospective analysis of GP skin cancer histopathology reports in three Scottish Health Boards over a 4-year period. Postal questionnaires were used to explore factors affecting surgeons' excision rates. GPs excised 895 skin cancers (4.5% of the 19 853 regional total) during the period. Of the basal cell carcinomas, 308 would be classified as low-risk by current National Institute for Health and Care Excellence criteria. Of the returned questionnaires, 58 accounted for 631 (70.5%) of the excised skin cancers. Analysing completeness of skin cancer excision, there was a statistically significant difference between GPs performing excision on ≥ 11 lesions/month compared with those performing excision on ≤ 10/month. Policymakers may wish to consider systems to facilitate low-risk patients being treated by GPs who undertake frequent surgical procedures.
英国的皮肤癌发病率正在上升，但许多地区的皮肤科医生短缺。我们通过对苏格兰三个卫生委员会四年间的全科医生皮肤癌组织病理学报告进行回顾性分析，旨在比较普通外科医生切除皮肤癌的比率，以确定与良好实践相关的因素。我们使用邮寄问卷来探讨影响外科医生切除率的因素。在这段时间里，全科医生切除了 895 例皮肤癌（占该地区 19853 例皮肤癌总数的 4.5%）。在这些基底细胞癌中，根据现行的英国国家健康与临床优化研究所标准，有 308 例可被归类为低风险。在返回的问卷中，有 58 份问卷占切除的 631 例（70.5%）皮肤癌。分析皮肤癌切除的完整性，每月切除≥11 例病变的医生与每月切除≤10 例病变的医生之间存在统计学显著差异。政策制定者可能希望考虑建立系统，以便让经常进行手术的全科医生为低风险患者提供治疗。
