The recognition and management of melanoma and other skin lesions by general practitioners in New Zealand.
OBJECTIVE
To assess current levels of knowledge and management practices with respect to melanoma and other skin cancers, in a representative sample of New Zealand general practitioners.


METHODS
A self-administered questionnaire was sent to a random sample of 900 general practitioners. The questionnaire included 12 cases with coloured photographs of skin lesions and a brief presenting history. Responders were asked to assess probable diagnosis, need for biopsy and management of the lesion. Other attitudinal and relevant background information was also gathered. The questionnaire was sent to a comparison sample of 35 dermatologists.


RESULTS
The overall response rate was 66% among the general practitioners and 68% among the dermatologists. The sample responding was representative of the larger population of doctors practising in New Zealand. Correct decisions whether or not to biopsy lesions (mean score of 10.1 out of 12) were significantly higher than the number of correct diagnoses (mean 8.4). Correct identification and recognition of the need to biopsy melanomas was high. Diagnostic skills and recognition of the need for biopsy were somewhat lower among general practitioners aged 50 years and over than among younger doctors. Doctors who had experience of a patient with melanoma had higher diagnostic skills and made more correct biopsy decisions. The general practitioners' scores for correct biopsy decisions were similar to those of the dermatologists sampled, although their diagnostic skills were somewhat lower, particularly with respect to nonmelanoma skin cancers.


CONCLUSIONS
The findings indicate a high level of expertise in terms of diagnosis of skin lesions and identification of need to biopsy suspicious lesions among general practitioners in this country.
Department of Preventive and Social Medicine, University of Otago Medical School, Dunedin.
R
R
McGee
M
M
Elwood
H
H
Adam
M J
MJ
Sneyd
S
S
Williams
M
M
Tilyard
D002983:Clinical Competence; D003880:Dermatology / Q000706:statistics & numerical data; D005194:Family Practice / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008545:Melanoma / Q000175:diagnosis / Q000628:therapy; D009520:New Zealand; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012017:Referral and Consultation; D012878:Skin Neoplasms / Q000175:diagnosis / Q000628:therapy