Excising squamous cell carcinomas

comparing the performance of GPs, hospital skin specialists and other hospital specialists

Elizabeth K Delaney, Laura Duckworth, W Douglas Thompson, Amanda J Lee, Peter Murchie

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background. GPs have no defined role in the excision of squamous cell carcinomas (SCCs). Current guidelines recommend that all skin lesions suspicious of SCC should be referred urgently to secondary care. Evidence regarding current management of SCC in primary care is limited. Existing audit data suggest that up to 10% of SCCs may be excised in primary care. GPs may be able to have a greater role in the management of SCC but more evidence is required before this can be advocated.
Objective. To compare the practice of GPs, skin specialists (dermatologists and plastic surgeons) and other hospital specialists in excising SCCs.
Methods A retrospective analysis of all SCCs excised in the Grampian region between 1 January and 31 December 2005. A total of 1184 reports were rated for source and adequacy of excision.
Results. GPs excised 23.7% of all SCC-positive biopsies. Whether the biopsy had been performed by a GP or a hospital skin specialist made no significant difference to excision adequacy. However, GPs were significantly more likely to excise adequately than hospital non-specialists (P < 0.001). Infrequent GP excisers appear to perform as well as frequent excisers in adequately excising SCCs.
Conclusions. GPs excise a considerable number of SCCs in primary care. GPs compare favourably to skin specialists in excising SCCs. The performance of infrequent GP excisers does not appear to differ significantly from that of frequent GP excisers. Further work is required to define more clearly the role of GPs in the management of SCCs.
Original languageEnglish
Pages (from-to)541-546
Number of pages6
JournalFamily Practice
Volume29
Issue number5
Early online date9 Feb 2012
DOIs
Publication statusPublished - Oct 2012

Fingerprint

Squamous Cell Carcinoma
Skin
Primary Health Care
Biopsy
Secondary Care
Guidelines

Keywords

  • cancer
  • diagnosis
  • primary health care
  • skin cancer
  • squamous cell carcinoma

Cite this

Excising squamous cell carcinomas : comparing the performance of GPs, hospital skin specialists and other hospital specialists. / Delaney, Elizabeth K; Duckworth, Laura; Thompson, W Douglas; Lee, Amanda J; Murchie, Peter.

In: Family Practice, Vol. 29, No. 5, 10.2012, p. 541-546.

Research output: Contribution to journalArticle

@article{a12a2ff820714ddcbd2ba12c995abcab,
title = "Excising squamous cell carcinomas: comparing the performance of GPs, hospital skin specialists and other hospital specialists",
abstract = "Background. GPs have no defined role in the excision of squamous cell carcinomas (SCCs). Current guidelines recommend that all skin lesions suspicious of SCC should be referred urgently to secondary care. Evidence regarding current management of SCC in primary care is limited. Existing audit data suggest that up to 10{\%} of SCCs may be excised in primary care. GPs may be able to have a greater role in the management of SCC but more evidence is required before this can be advocated. Objective. To compare the practice of GPs, skin specialists (dermatologists and plastic surgeons) and other hospital specialists in excising SCCs. Methods A retrospective analysis of all SCCs excised in the Grampian region between 1 January and 31 December 2005. A total of 1184 reports were rated for source and adequacy of excision. Results. GPs excised 23.7{\%} of all SCC-positive biopsies. Whether the biopsy had been performed by a GP or a hospital skin specialist made no significant difference to excision adequacy. However, GPs were significantly more likely to excise adequately than hospital non-specialists (P < 0.001). Infrequent GP excisers appear to perform as well as frequent excisers in adequately excising SCCs. Conclusions. GPs excise a considerable number of SCCs in primary care. GPs compare favourably to skin specialists in excising SCCs. The performance of infrequent GP excisers does not appear to differ significantly from that of frequent GP excisers. Further work is required to define more clearly the role of GPs in the management of SCCs.",
keywords = "cancer, diagnosis , primary health care, skin cancer, squamous cell carcinoma",
author = "Delaney, {Elizabeth K} and Laura Duckworth and Thompson, {W Douglas} and Lee, {Amanda J} and Peter Murchie",
year = "2012",
month = "10",
doi = "10.1093/fampra/cms007",
language = "English",
volume = "29",
pages = "541--546",
journal = "Family Practice",
issn = "0263-2136",
publisher = "Oxford University Press",
number = "5",

}

TY - JOUR

T1 - Excising squamous cell carcinomas

T2 - comparing the performance of GPs, hospital skin specialists and other hospital specialists

AU - Delaney, Elizabeth K

AU - Duckworth, Laura

AU - Thompson, W Douglas

AU - Lee, Amanda J

AU - Murchie, Peter

PY - 2012/10

Y1 - 2012/10

N2 - Background. GPs have no defined role in the excision of squamous cell carcinomas (SCCs). Current guidelines recommend that all skin lesions suspicious of SCC should be referred urgently to secondary care. Evidence regarding current management of SCC in primary care is limited. Existing audit data suggest that up to 10% of SCCs may be excised in primary care. GPs may be able to have a greater role in the management of SCC but more evidence is required before this can be advocated. Objective. To compare the practice of GPs, skin specialists (dermatologists and plastic surgeons) and other hospital specialists in excising SCCs. Methods A retrospective analysis of all SCCs excised in the Grampian region between 1 January and 31 December 2005. A total of 1184 reports were rated for source and adequacy of excision. Results. GPs excised 23.7% of all SCC-positive biopsies. Whether the biopsy had been performed by a GP or a hospital skin specialist made no significant difference to excision adequacy. However, GPs were significantly more likely to excise adequately than hospital non-specialists (P < 0.001). Infrequent GP excisers appear to perform as well as frequent excisers in adequately excising SCCs. Conclusions. GPs excise a considerable number of SCCs in primary care. GPs compare favourably to skin specialists in excising SCCs. The performance of infrequent GP excisers does not appear to differ significantly from that of frequent GP excisers. Further work is required to define more clearly the role of GPs in the management of SCCs.

AB - Background. GPs have no defined role in the excision of squamous cell carcinomas (SCCs). Current guidelines recommend that all skin lesions suspicious of SCC should be referred urgently to secondary care. Evidence regarding current management of SCC in primary care is limited. Existing audit data suggest that up to 10% of SCCs may be excised in primary care. GPs may be able to have a greater role in the management of SCC but more evidence is required before this can be advocated. Objective. To compare the practice of GPs, skin specialists (dermatologists and plastic surgeons) and other hospital specialists in excising SCCs. Methods A retrospective analysis of all SCCs excised in the Grampian region between 1 January and 31 December 2005. A total of 1184 reports were rated for source and adequacy of excision. Results. GPs excised 23.7% of all SCC-positive biopsies. Whether the biopsy had been performed by a GP or a hospital skin specialist made no significant difference to excision adequacy. However, GPs were significantly more likely to excise adequately than hospital non-specialists (P < 0.001). Infrequent GP excisers appear to perform as well as frequent excisers in adequately excising SCCs. Conclusions. GPs excise a considerable number of SCCs in primary care. GPs compare favourably to skin specialists in excising SCCs. The performance of infrequent GP excisers does not appear to differ significantly from that of frequent GP excisers. Further work is required to define more clearly the role of GPs in the management of SCCs.

KW - cancer

KW - diagnosis

KW - primary health care

KW - skin cancer

KW - squamous cell carcinoma

U2 - 10.1093/fampra/cms007

DO - 10.1093/fampra/cms007

M3 - Article

VL - 29

SP - 541

EP - 546

JO - Family Practice

JF - Family Practice

SN - 0263-2136

IS - 5

ER -