Audit offers participants a retrospective assessment of their diagnosis and management of cutaneous malignancy. Participants will receive statistically relevant feedback and evaluate via systemic reviews, their own clinical performance against other participants and best practice guidelines. Quality of care will be improved by increasing participants awareness of diagnostic accuracy and adequacy of surgical excision of skin lesions.
Relevance to General Practice
Non-melanoma skin canacer (NMSC), which includes basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) is the most common and expensive cancer in Australia and places a high burden on the population, health care system and government. Australia has the highest incidence of NMSC in the world.(1)
General practitioners are the primary contact point for the vast majority of skin cancer patients. A previous study has determined biopsy/excision rates of 2.5/week GPs and 34/week for skin cancer clinic doctors.(2) Wide variations in treatment practices and recommendations give to patients have been previously noted. Inadequate primary treatment of skin malignancy can lead to morbidity and mortality.
1. Clinical Practice Guide: BCC, SCC (and related lesions), Cancer Council Australia/Aust Cancer Network, 2008,p6.
2. Youl, P et al: Diagnosing skin cancer in primary care: how do mainstream practitioners compare with primary care skin cancer clinic doctors?" MJA, 2007: 187: 215-220.
- Illustrate the importance of obtaining clear surgical margins for the treatment of skin cancer malignancy, including margin sizes for treatment of melanoma.
- Extrapolate from audit & pathology reports and clinical practice guidelines the appropriate follow up procedures for patients with inadequately excised tumours.
- Implement skin cancer management pathways within their practices to assist in handling a major public health issue.
- Identify undertreated patients, the importance of follow-up protocols and processes (particularly inadequate excisions) in own practice as a result of audit.
- Utilise Cancer Council Aus/Aus Cancer Network and NHMRC Guidelines to identify effective follow-up, referral pathways & options to ensure continuity of care
Domains of General Practice
D1. Communication skills and the patient-doctor relationship
D2. Applied professional knowledge and skills
D3. Population health and the context of general practice
D4. Professional and ethical role
D5. Organisational and legal dimensions
Curriculum Contextual Units