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Choosing to biopsy or refer suspicious melanocytic lesions in general practice

BACKGROUND: General practitioners (GPs) are involved in the management of most melanocytic skin lesions in Australia. A high quality biopsy technique is a crucial first step in management, as it is recognized that poor techniques can mislead, delay, or miss a diagnosis of melanoma. There has been li...

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Autores principales: Robison, Sean, Kljakovic, Marjan, Barry, Peter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3526551/
https://www.ncbi.nlm.nih.gov/pubmed/22873705
http://dx.doi.org/10.1186/1471-2296-13-78
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author Robison, Sean
Kljakovic, Marjan
Barry, Peter
author_facet Robison, Sean
Kljakovic, Marjan
Barry, Peter
author_sort Robison, Sean
collection PubMed
description BACKGROUND: General practitioners (GPs) are involved in the management of most melanocytic skin lesions in Australia. A high quality biopsy technique is a crucial first step in management, as it is recognized that poor techniques can mislead, delay, or miss a diagnosis of melanoma. There has been little published on the biopsy decisions and techniques of GPs. This study aims to describe the current management choices made by GPs for suspicious melanocytic skin lesions and to compare their choices with the best practice guidelines. METHODS: An anonymous survey of GPs presented with three clinical scenarios with increasing complexity of melanoma in which a referral or biopsy decision was specified. RESULTS: 391 mailed surveys with a 76.3% response rate. Mean biopsy experience was 4.14 biopsies per GP per month. The rates of choosing to refer among the three scenarios were 31%, 52% and 81% respectively, with referral to surgery being the most common choice (81%). Most biopsy techniques (55%) were chosen according to best practice guidelines, although non-guideline biopsy techniques chosen included shave (n = 10), punch biopsy (n = 57), wide excisions (n = 65), and flaps (n = 10). The few GPs (n = 5) who identified themselves as skin specialist GPs were no more likely to adhere to guidelines than their colleagues. CONCLUSION: A majority of referrals and biopsies were chosen by GPs according to best practice guidelines, but concern remains for the high proportion of GPs making non-guideline based choices. How GPs choose to biopsy or refer needs further training, audit, and research if Australia is to improve the outcome of melanoma management in general practice.
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spelling pubmed-35265512012-12-20 Choosing to biopsy or refer suspicious melanocytic lesions in general practice Robison, Sean Kljakovic, Marjan Barry, Peter BMC Fam Pract Research Article BACKGROUND: General practitioners (GPs) are involved in the management of most melanocytic skin lesions in Australia. A high quality biopsy technique is a crucial first step in management, as it is recognized that poor techniques can mislead, delay, or miss a diagnosis of melanoma. There has been little published on the biopsy decisions and techniques of GPs. This study aims to describe the current management choices made by GPs for suspicious melanocytic skin lesions and to compare their choices with the best practice guidelines. METHODS: An anonymous survey of GPs presented with three clinical scenarios with increasing complexity of melanoma in which a referral or biopsy decision was specified. RESULTS: 391 mailed surveys with a 76.3% response rate. Mean biopsy experience was 4.14 biopsies per GP per month. The rates of choosing to refer among the three scenarios were 31%, 52% and 81% respectively, with referral to surgery being the most common choice (81%). Most biopsy techniques (55%) were chosen according to best practice guidelines, although non-guideline biopsy techniques chosen included shave (n = 10), punch biopsy (n = 57), wide excisions (n = 65), and flaps (n = 10). The few GPs (n = 5) who identified themselves as skin specialist GPs were no more likely to adhere to guidelines than their colleagues. CONCLUSION: A majority of referrals and biopsies were chosen by GPs according to best practice guidelines, but concern remains for the high proportion of GPs making non-guideline based choices. How GPs choose to biopsy or refer needs further training, audit, and research if Australia is to improve the outcome of melanoma management in general practice. BioMed Central 2012-08-08 /pmc/articles/PMC3526551/ /pubmed/22873705 http://dx.doi.org/10.1186/1471-2296-13-78 Text en Copyright ©2012 Robison et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Robison, Sean
Kljakovic, Marjan
Barry, Peter
Choosing to biopsy or refer suspicious melanocytic lesions in general practice
title Choosing to biopsy or refer suspicious melanocytic lesions in general practice
title_full Choosing to biopsy or refer suspicious melanocytic lesions in general practice
title_fullStr Choosing to biopsy or refer suspicious melanocytic lesions in general practice
title_full_unstemmed Choosing to biopsy or refer suspicious melanocytic lesions in general practice
title_short Choosing to biopsy or refer suspicious melanocytic lesions in general practice
title_sort choosing to biopsy or refer suspicious melanocytic lesions in general practice
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3526551/
https://www.ncbi.nlm.nih.gov/pubmed/22873705
http://dx.doi.org/10.1186/1471-2296-13-78
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