title: Are General Physicians Prepared for Struggling Skin Cancer?-Cross-Sectional Study.
abstract: The aim of this study is to evaluate the role of general practitioners (GP) in selecting higher risk population for skin cancer screening. GP's training was organized to examine a specific high risk population consisting mainly of fisherman and farmers in a city of North of Portugal. Health care professionals of local health units training was performed by two dermatologists 2 months before the screening. During 8 weeks GPs selected patients with skin cancer suspicious lesions and/or risk factors consecutively from their regular consultation. These selected patients were referred to a dermatologist evaluation. Six dermatologists using manual dermoscopy examined the previously selected patients. One hundred eight patients have been screened, 35 % of which were males and 65 % females, with a mean age of 54 years. Full skin evaluation by dermatologists revealed 31 % of actinic keratosis, 5 % of leucoplasia, 7 % of basal cell carcinoma, 8 % of squamous cell carcinoma, and 1 % of melanoma. Cohen's kappa coefficient between dermatologist and GPs was 0.18. Selective screening with collaboration of GPs allowed the detection of more cases of skin cancer than the nonselective screenings in the literature. Although the diagnostic agreement between GPs and dermatologists was not good, our results indicate that active collaboration of dermatologists with primary health care units for selective skin cancer screening, including post graduated courses on their own health units, can be a way of optimizing early detection of cutaneous pre malignant and malignant lesions.
authors.affiliation: Centro de Dermatologia Epidermis, Instituto CUF, Apartado 55031, 4050-401, Porto, Portugal. duarte.af.t30@gmail.com.
authors.forename: Ana Filipa
authors.identifier: 0000-0001-6032-4603
authors.initials: AF
authors.lastname: Duarte
authors.affiliation: Center for Health Technology and Services Research (CINTESIS) and Department of Health Information and Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
authors.forename: Altamiro
authors.initials: A
authors.lastname: da Costa-Pereira
authors.affiliation: Dermatology Department Hopital Erasme, Université Libre de Bruxelles, Brussels, Belgium.|Euromelanoma Europe Chair, Brussels, Belgium.
authors.forename: Veronique
authors.initials: V
authors.lastname: Del-Marmol
authors.affiliation: Centro de Dermatologia Epidermis, Instituto CUF, Apartado 55031, 4050-401, Porto, Portugal.|Immunology Department, Faculty of Medicine, University of Porto, Porto, Portugal.|Portuguese Skin Cancer Association, Porto, Portugal.
authors.forename: Osvaldo
authors.initials: O
authors.lastname: Correia
mesh_terms: D002280:Basal Cell Carcinoma / Q000175:diagnosis; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D004502:Education, Medical, Continuing / Q000592:standards*; D005260:Female; D058005:General Practitioners / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012878:Skin Neoplasms / Q000175:diagnosis*
keywords: General physicians; Screening; Skin cancer