Timely diagnosis of cutaneous squamous cell carcinoma: the GP's role.
BACKGROUND
Cutaneous squamous cell carcinoma (SCC) is the second most frequent skin cancer among Caucasians. Advanced cases determine significant tissue destruction and they can metastasize.


OBJECTIVE
To evaluate the role of GPs in timely diagnosis of SCC, examining the probability of delay before the diagnosis and treatment of SCC among patients having first seen a GP compared to patients having accessed directly a dermatologist.


METHODS
We included a stratified sample of 308 SCC patients treated at a referral center in Italy. Medical records were reviewed and combined with patient interviews.


RESULTS
Multivariable analysis has shown that patients who have first seen a GP have a significantly lower likelihood of long patient delay [odds ratio (OR) = 0.45; 95% confidence interval (95% CI) 0.21-0.94; P = 0.04) compared to patients having accessed directly a dermatologist. Treatment delay was not associated with the specialization of the first doctor seen for the lesion (OR = 0.52; 95% CI 0.15-1.84; P = 0.31).


CONCLUSIONS
Our findings highlight the potential role of the GP in facilitating rapid access to appropriate health care.
Clinical Epidemiology Unit, Istituto Dermopatico dell’Immacolata-Istituto di Ricovero e Cura a Carattere Scientifico (IDI-IRCCS), Rome, Italy. c.renzi@idi.it
Cristina
C
Renzi
Simona
S
Mastroeni
Thomas J
TJ
Mannooranparampil
Francesca
F
Passarelli
Paolo
P
Pasquini
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000628:therapy; D003430:Cross-Sectional Studies; D057210:Delayed Diagnosis / Q000706:statistics & numerical data; D055088:Early Detection of Cancer / Q000706:statistics & numerical data; D005260:Female; D058005:General Practitioners; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010819:Physician's Role; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000628:therapy