title: Skin tumour surgery in primary care: do general practitioners need to improve their surgical skills?
abstract: BACKGROUND
  Due to a rapid increase in the incidence of skin cancer, it seems inevitable that general practitioners (GPs) will play a larger role in skin cancer care.
  
  
  OBJECTIVE
  To assess surgical procedures used by GPs in skin tumour management.
  
  
  METHODS
  We performed a retrospective study of 1,898 pathology reports of skin tumours excised by GPs in 2009.
  
  
  RESULTS
  In 22.9% no diagnosis was provided on the application form. Mostly, once-off excisions (no preceding biopsy) were performed, 7% of the excised lesions were malignant, and 35% of incisions were incomplete. Excisions in the face and neck region were incomplete in 65.4%; 22% of melanomas were biopsied or shaved.
  
  
  CONCLUSIONS
  This study underlines the difficulties in skin tumour management in primary care. To stimulate adequate resource use, the number of excisions of benign lesions could be lowered, and pretreatment biopsy in non-melanoma skin cancer management should be encouraged. GPs should be aware of their limitations and consider referral of high-risk malignancies.
authors.affiliation: Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Margit C J
authors.initials: MC
authors.lastname: van Rijsingen
authors.forename: Robin
authors.initials: R
authors.lastname: Vossen
authors.forename: Barbara E W L
authors.initials: BE
authors.lastname: van Huystee
authors.forename: Wim J M J
authors.initials: WJ
authors.lastname: Gorgels
authors.forename: Marie-Jeanne P
authors.initials: MJ
authors.lastname: Gerritsen
mesh_terms: D001706:Biopsy / Q000379:methods / Q000592:standards; D001913:Bowen's Disease / Q000473:pathology / Q000601:surgery*; D002280:Basal Cell Carcinoma / Q000473:pathology / Q000601:surgery*; D002983:Clinical Competence; D062109:Dermatologic Surgical Procedures / Q000592:standards*; D005121:Extremities; D005153:Facial Neoplasms / Q000473:pathology / Q000601:surgery*; D058006:General Practice / Q000592:standards*; D006801:Humans; D055623:Keratosis, Actinic / Q000473:pathology / Q000601:surgery; D008545:Melanoma / Q000473:pathology / Q000601:surgery*; D018365:Neoplasm, Residual; D011320:Primary Health Care / Q000592:standards; D012189:Retrospective Studies; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D060726:Torso