Skin cancer in general practice in South Australia. A five year study.

OBJECTIVE: Most data on the prevalence and behaviour of skin cancers is based on hospital studies. The scarcity of community based general practice skin surveys prompted this study. The aim of the survey was to: record the relative frequency of different skin tumours in an Adelaide general practice and compare these with rates published elsewhere. to record clinical accuracy of diagnosis, infection rates and completeness of excision.
METHOD: Five year prospective study recording age, sex, site of excision and histological diagnosis of 369 skin excisions in a general practice. A substudy recorded clinical diagnostic accuracy, with subsequent histological diagnosis.
RESULTS: Non-melanotic skin cancer (NMSC) accounted for 59.9% of the total lesions with basal cell carcinomas (BCCs) accounting for 30.6%, squamous cell carcinomas (SCCs) 21.7%, and intra epithelial cancer 7.6%. The most frequent excision site was head, neck and face. A total of 75% of SCCs occurred on sun exposed areas, whereas a significant proportion of BCCs occurred on the shoulder and trunk (37.1%); this agrees with recent trends in Australia. Clinical accuracy when compared with histology was 77% comparing favourably with other published data.
CONCLUSION: Skin cancer continues to be a major community health issue in Australia in which general practitioners are heavily involved. Due to their expertise and early intervention at a community level, much is being done to reduce this cost in the community. Further research on NMSC trends are needed, especially in general practice.