title: Body-site distribution of skin cancer, pre-malignant and common benign pigmented lesions excised in general practice.
abstract: BACKGROUND
  Concern about skin cancer is a common reason for people from predominantly fair-skinned populations to present to primary care doctors.
  
  
  OBJECTIVE
  To examine the frequency and body-site distribution of malignant, pre-malignant and benign pigmented skin lesions excised in primary care.
  
  
  METHODS
  This prospective study conducted in Queensland, Australia, included 154 primary care doctors. For all excised or biopsied lesions, doctors recorded the patient's age and sex, body site, level of patient pressure to excise, and the clinical diagnosis. Histological confirmation was obtained through pathology laboratories.
  
  
  RESULTS
  Of 9650 skin lesions, 57·7% were excised in males and 75·0% excised in patients ≥ 50 years. The most common diagnoses were basal cell carcinoma (BCC) (35·1%) and squamous cell carcinoma (SCC) (19·7%). Compared with the whole body, the highest densities for SCC, BCC and actinic keratoses were observed on chronically sun-exposed areas of the body including the face in males and females, the scalp and ears in males, and the hands in females. The density of BCC was also high on intermittently or rarely exposed body sites. Females, younger patients and patients with melanocytic naevi were significantly more likely to exert moderate/high levels of pressure on the doctor to excise.
  
  
  CONCLUSIONS
  More than half the excised lesions were skin cancer, which mostly occurred on the more chronically sun-exposed areas of the body. Information on the type and body-site distribution of skin lesions can aid in the diagnosis and planned management of skin cancer and other skin lesions commonly presented in primary care.
authors: Viertel Centre for Research in Cancer Control, Cancer Council Queensland, Spring Hill, Qld, Australia. pipyoul@cancerqld.org.au
authors: P H
authors: PH
authors: Youl
authors: M
authors: M
authors: Janda
authors: J F
authors: JF
authors: Aitken
authors: C B
authors: CB
authors: Del Mar
authors: D C
authors: DC
authors: Whiteman
authors: P D
authors: PD
authors: Baade
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001315:Australia / Q000453:epidemiology; D002280:Basal Cell Carcinoma / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D055623:Keratosis, Actinic / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009506:Nevus / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D011230:Precancerous Conditions / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D011446:Prospective Studies; D011793:Queensland; D017678:Sex Distribution; D012878:Skin Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery