Are General Physicians Prepared for Struggling Skin Cancer?—Cross-Sectional Study
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The aim of this study is to evaluate the role of general practitioners (GP) in selecting higher risk population for skin cancer screening. GP’s training was organized to examine a specific high risk population consisting mainly of fisherman and farmers in a city of North of Portugal. Health care professionals of local health units training was performed by two dermatologists 2 months before the screening. During 8 weeks GPs selected patients with skin cancer suspicious lesions and/or risk factors consecutively from their regular consultation. These selected patients were referred to a dermatologist evaluation. Six dermatologists using manual dermoscopy examined the previously selected patients. One hundred eight patients have been screened, 35 % of which were males and 65 % females, with a mean age of 54 years. Full skin evaluation by dermatologists revealed 31 % of actinic keratosis, 5 % of leucoplasia, 7 % of basal cell carcinoma, 8 % of squamous cell carcinoma, and 1 % of melanoma. Cohen’s kappa coefficient between dermatologist and GPs was 0.18. Selective screening with collaboration of GPs allowed the detection of more cases of skin cancer than the nonselective screenings in the literature. Although the diagnostic agreement between GPs and dermatologists was not good, our results indicate that active collaboration of dermatologists with primary health care units for selective skin cancer screening, including post graduated courses on their own health units, can be a way of optimizing early detection of cutaneous pre malignant and malignant lesions.
KeywordsSkin cancer Screening General physicians
The authors thank the Portuguese Skin Cancer Association, namely its president Dr. António Picoto, GPs and nurses of the Póvoa—Vila do Conde health care unit, especially Dra. Vanda Monteiro, Dr. Ramon Gomez, Dra. Rosália Braga, the dermatologists who cooperate in the study (Dr. Ana Margarida Barros, Dr. Natividade Rocha, Dr. Ana Nogueira, and Dr. Aristoteles Rosmaninho), and Orquídea Ribeiro for the statistical analysis.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
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