title: Referrals by general practitioners for suspicious skin lesions: the urgency of training.
abstract: Skin cancer is common among white populations and rapid increases in incidence are being observed in many countries, leading to a large burden on healthcare systems. Unnecessary referrals from general practitioners (GPs) may contribute to this burden. The aim of this study was to analyse the quality of referrals from GPs of patients with skin tumours. Referral letters for 734 patients were collected. The proposed diagnoses were compared with definitive diagnosis made by dermatologists. In 44.5%, lesions appeared to be benign. Malignant skin tumours were poorly recognised by GPs and seborrheic keratoses were often mistaken for naevi (33.6%). Furthermore, with total body examination, dermatologists found 111 additional malignant lesions. We discussed several recommendations to minimise unnecessary referrals as well as the future role of GPs in skin cancer care.
authors.affiliation: Department of Dermatology, Radboud University Nijmegen Medical Centre, 6500 HB Nijmegen, The Netherlands. m.vanrijsingen@derma.umcn.nl.
authors.forename: Margit C J
authors.initials: MC
authors.lastname: van Rijsingen
authors.forename: Sabine C A
authors.initials: SC
authors.lastname: Hanssen
authors.forename: Joannes M M
authors.initials: JM
authors.lastname: Groenewoud
authors.forename: Gert Jan
authors.initials: GJ
authors.lastname: van der Wilt
authors.forename: Marie-Jeanne P
authors.initials: MJ
authors.lastname: Gerritsen
mesh_terms: D002280:Basal Cell Carcinoma / Q000175:diagnosis; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis; D003880:Dermatology; D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000706:statistics & numerical data*; D005260:Female; D058005:General Practitioners / Q000193:education / Q000706:statistics & numerical data*; D006801:Humans; D017492:Keratosis, Seborrheic / Q000175:diagnosis; D008297:Male; D008545:Melanoma / Q000175:diagnosis; D008875:Middle Aged; D009426:Netherlands; D009506:Nevus / Q000175:diagnosis; D011230:Precancerous Conditions / Q000175:diagnosis; D011237:Predictive Value of Tests; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012878:Skin Neoplasms / Q000175:diagnosis*; D009626:Terminology as Topic