Management of skin cancer in Australia: a comparison of general practice and skin cancer clinics

Byrnes, Patrick, Ackermann, Evan, Williams, Ian Douglas, Mitchell, Geoffrey K. and Askew, Deborah (2007) Management of skin cancer in Australia: a comparison of general practice and skin cancer clinics. Australian Family Physician, 36 12: 1073-1075.

Author Byrnes, Patrick
Ackermann, Evan
Williams, Ian Douglas
Mitchell, Geoffrey K.
Askew, Deborah
Title Management of skin cancer in Australia: a comparison of general practice and skin cancer clinics
Journal name Australian Family Physician   Check publisher's open access policy
ISSN 0300-8495
Publication date 2007-12-12
Year available 2007
Sub-type Article (original research)
Open Access Status Not yet assessed
Volume 36
Issue 12
Start page 1073
End page 1075
Total pages 3
Editor B. Vassiliadis
Place of publication South Melbourne, Australia
Publisher Royal Australian College of General Practitioners
Language eng
Subject 321208 Primary Health Care
730299 Public health not elsewhere classified
111717 Primary Health Care
Abstract BACKGROUND: Skin cancer is common in Australia and its increasing incidence has been matched by an increase in specifically focused skin cancer clinics staffed by general practitioners. This study compares the management of skin cancer in general practice with that of skin cancer clinic networks. METHODS: Analysis of billing data relating to management of skin cancer from 1 July 2005 to 30 June 2006 in three Queensland general practices (metropolitan, provincial, and rural) representing 23 100 patients and 23 doctors. As far as possible, methods were matched to those used in two published studies of skin cancer clinics. RESULTS: Of the 1417 skin cancers: 31 melanomas and 1361 nonmelanoma skin cancers (NMSC) were treated by excision, and 25 NMSC were treated nonsurgically. The biopsy to treatment ratio in general practice was 0.7 and the number needed to treat (NNT) was 39, compared with 3.1 and 29 in one skin cancer clinic network and 0.5 and 24 in the other. Eighty-seven percent of skin cancer excisions were closed by primary repair and 54% of all excised lesions were malignant, compared with 42 and 60% in one network and 76 and 46% in the other, respectively. DISCUSSION: The benign to malignant excision rate was similar in general practice and the skin cancer clinic networks, but one network reported very different rates of biopsy and complex wound closure. This raises questions as to whether outcomes are improved by these measures. These results demonstrate the usefulness of three billing data outcome measures in comparing activity in different clinical settings. However, the billing based NNT may not be a useful measure. (author abstract)
Keyword Primary Health Care
Medicine, General & Internal
General & Internal Medicine
Q-Index Code C1
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
2008 Higher Education Research Data Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 12 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 12 times in Scopus Article | Citations
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Created: Thu, 03 Apr 2008, 22:15:38 EST by Brenda Mason on behalf of General Practice SOMC