Skin cancer biopsies 'safe in primary care'

Skin cancer biopsies by GPs are as effective as those in secondary care, research suggests.

A scanning electron micrograph of a melanoma cancer cell (Photo: SPL)
A scanning electron micrograph of a melanoma cancer cell (Photo: SPL)

Despite concerns about diagnostic excision biopsy of melanoma by GPs, UK researchers found no difference in survival rates compared with secondary care.

Writing in the BJGP, they said current guidelines, which advise GPs immediately to refer suspicious skin lesions to secondary care, 'may not support earliest diagnosis and best long-term outcomes'.

Patients receiving initial biopsy by a GP in the UK are commonly perceived to have been mismanaged, researchers said. Yet in Australia, where melanoma is more common and survival rates higher, most are initially biopsied by GPs.

Researchers led by Dr Peter Murchie at the University of Aberdeen looked at data on 1,263 patients with cutaneous melanoma diagnosed in Scotland.

They compared the resulting morbidity and survival rates of 262 patients who had their biopsy in primary care with 1,001 patients seen in secondary care. Analysis found no difference in either of these rates between the two groups.

The primary care group had fewer hospital admissions and spent fewer days in hospital.

The study authors said patients who have had a melanoma inadvertently excised in primary care could be 'reassured that this does not mean poorer outcomes'.

They added: 'A randomised trial to definitively establish the role of primary care in melanoma management in the UK is needed.'

Last year, the RCGP launched a scheme to gather national evidence for the safety and quality of GP minor surgery.

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