Dermatology Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Institute of Experimental and Clinical Research (IREC), UCLouvain, Brussels, Belgium.
J Cancer Educ. 2021 Dec;36(6):1316-1324. doi: 10.1007/s13187-020-01770-w.
General practitioners (GPs) are among the main actors involved in early melanoma diagnosis. However, melanoma diagnostic accuracy and management are reported to be insufficient among GPs in Europe. The primary aim of this observational prospective study was to shed light on melanoma diagnostic practices among French-speaking Belgian GPs. The second aim was to specifically analyse these GPs' pigmented skin lesion diagnostic accuracy and management. GPs from the five French-speaking districts of Belgium were asked to complete a questionnaire, before taking part in a melanoma diagnostic training session. First, we assessed the GPs' current melanoma diagnostic practices. Then, their pigmented skin lesion diagnostic accuracy and management were evaluated, through basic theoretical questions and clinical images. These results were subsequently analysed, according to the GPs' sociodemographic characteristics and medical practice type. In total, 89 GPs completed the questionnaire. Almost half of the GPs (43%; CI = [33;54]) were confronted with a suspicious skin lesion as the main reason for consultation once every 3 months, while 33% (CI = [24;43]) were consulted for a suspicious lesion as a secondary reason once a month. Prior to training, one-third of the GPs exhibited suboptimal diagnostic accuracy in at least one of six "life-threatening" clinical cases among two sets of 10 clinical images of pigmented skin lesions, which can lead to inadequate patient management (i.e. incorrect treatment and/or inappropriate reinsurance). This study underlines the need to train GPs in melanoma diagnosis. GPs' pigmented skin lesion diagnostic accuracy and management should be improved to increase early melanoma detection.
全科医生（GP）是早期黑色素瘤诊断的主要参与者之一。然而，在欧洲，GP 的黑色素瘤诊断准确性和管理被报道不足。本观察性前瞻性研究的主要目的是阐明法国比利时语区 GP 的黑色素瘤诊断实践。第二个目的是专门分析这些 GP 的色素性皮肤病变的诊断准确性和管理。要求比利时五个法语区的 GP 填写一份问卷，然后参加黑色素瘤诊断培训课程。首先，我们评估了 GP 当前的黑色素瘤诊断实践。然后，通过基本理论问题和临床图像评估他们的色素性皮肤病变诊断准确性和管理。根据 GP 的社会人口统计学特征和医疗实践类型分析这些结果。共有 89 名 GP 完成了问卷。近一半的 GP（43%；置信区间 [33；54]）每三个月因可疑皮肤病变作为主要就诊原因就诊一次，而 33%（置信区间 [24；43]）每月因可疑病变作为次要就诊原因就诊一次。在培训之前，三分之一的 GP 在两组 10 张色素性皮肤病变临床图像中的至少一个“危及生命”的临床病例中表现出诊断准确性不足，这可能导致患者管理不当（即不正确的治疗和/或不当的再保险）。这项研究强调了培训 GP 进行黑色素瘤诊断的必要性。GP 的色素性皮肤病变诊断准确性和管理需要提高，以增加早期黑色素瘤的发现率。
