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皮肤黑色素瘤的诊断:巴西人群中全科医生和皮肤科医生知识之间的差距。

Diagnosis of Cutaneous Melanoma: the Gap Between the Knowledge of General Practitioners and Dermatologists in a Brazilian Population.

机构信息

Faculdade Ciências Médicas de Minas Gerais, School of Medicine, Alameda Ezequiel Dias 275, Belo Horizonte, 30130-110, Brazil.

Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.

出版信息

J Cancer Educ. 2020 Aug;35(4):819-825. doi: 10.1007/s13187-020-01735-z.

Abstract

The early diagnosis of cutaneous melanoma provides less aggressive treatment reducing mortality. General practitioners are responsible for cancer diagnoses in the Brazilian Public Health System and therefore play a crucial role in the prevention and early detection of melanoma. To assess the melanoma knowledge of a primary healthcare physician, the general practitioner, compared to a dermatologist. General practitioners and dermatologists answered a questionnaire about melanoma and the management of suspected cases. The results of both groups were compared. The sample consisted of 80 specialists and 160 general practitioners. When asked about the "ABCDE" rule, 96.2% of the dermatologists knew about it, compared to 34.4% of the general practitioners. The percentage of dermatologists who examined the whole skin of the patient at high risk for melanoma was 90% vs. 24.5% amongst general practitioners. The most cited reasons for the absence of the examination of patients at risk for melanoma were lack of time at the consultations (17.6% specialists, 66.1% generalists) and an excessive number of patients (17.6% specialists, 61.5% generalists). General practitioner has less knowledge about melanoma compared to the dermatologists and presents deficient behaviors about patients at risk or who have suspicious lesions, indicating the need for training and continuing education.

摘要

早期诊断皮肤黑色素瘤可提供侵袭性较小的治疗方法,降低死亡率。全科医生负责巴西公共卫生系统中的癌症诊断,因此在预防和早期发现黑色素瘤方面发挥着至关重要的作用。为了评估初级保健医生(全科医生)对黑色素瘤的了解程度,我们将其与皮肤科医生进行了比较。全科医生和皮肤科医生回答了有关黑色素瘤和疑似病例管理的问卷。比较了两组的结果。该样本由 80 名专家和 160 名全科医生组成。当被问及“ABCDE”规则时,96.2%的皮肤科医生知道,而全科医生的比例为 34.4%。在有黑色素瘤高风险的患者中检查全身皮肤的皮肤科医生比例为 90%,而全科医生的比例为 24.5%。未对黑色素瘤高危患者进行检查的最常见原因是就诊时缺乏时间(17.6%的专家,66.1%的全科医生)和患者人数过多(17.6%的专家,61.5%的全科医生)。全科医生对黑色素瘤的了解程度低于皮肤科医生,并且对有风险或有可疑病变的患者的行为存在缺陷,这表明需要培训和继续教育。

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