ReportsDiagnostic ability of general practitioners and dermatologists in discriminating pigmented skin lesions☆,☆☆,★
Section snippets
Methods
During 1998, a health education program on melanoma was launched for GPs in the province of East-Flanders, Belgium. The objective was to bring an update on risk groups, clinical aspects, differential diagnosis, and management of melanoma by organizing lectures on this topic. Their capacity to diagnose pigmented skin lesions was tested concurrently before and after the course. In May 1997 an invitation was addressed to all 67 GP educational groups (representing 1956 GPs) of the province. Eight
Results
There are important differences between dermatologists and GPs as to the frequency with which they are asked advice for pigmented skin lesions (Table I). Whereas 95% of the dermatologists are consulted for a pigmented lesion at least once a week and more than half of them even daily, only 18% of the GPs are presented a pigmented lesion once in a week. For most GPs (61%) such advice is asked only once every week to 2 months. Similarly the frequency of melanoma cases seen in general practice is
Discussion
The ability of physicians to recognize pigmented skin lesions and melanoma can be investigated either prospectively, retrospectively, or in an experimental setting. In the prospective setting, usually a screening program, the clinical diagnosis is compared with the eventual outcome (eg, biopsy result, patient registered in a cancer registry).4, 5, 6 Follow-up of these patients is usually elaborate, especially of those in whom no suspect lesions were noted. Hence there is a danger of
References (28)
- et al.
Melanoma/skin cancer screening clinics: experiences in the Netherlands
J Am Acad Dermatol
(1991) - et al.
Who removes pigmented lesions? A study of the ratio of melanoma to other benign pigmented tumors removed by different categories of physicians in Australia in 1989 and 1994
J Am Acad Dermatol
(1997) - et al.
False-negative findings in skin cancer and melanoma screening
J Am Acad Dermatol
(1995) - et al.
How well do physicians recognize melanoma and other problem lesions?
J Am Acad Dermatol
(1986) - et al.
Quality of care: issue or oversight in health care reform?
J Am Acad Dermatol
(1996) - et al.
Patient and physician delay in melanoma diagnosis
J Am Acad Dermatol
(1988) - et al.
The cost of initiating appropriate therapy for skin diseases: a comparison of dermatologists and family physicians
J Am Acad Dermatol
(1983) - et al.
In vivo epiluminescence microscopy: improvement in the early diagnosis of melanoma
J Invest Dermatol
(1993) - et al.
Diagnostic accuracy: a new approach to its evaluation
Arch Dermatol
(1965) - et al.
Accuracy in the clinical diagnosis of malignant melanoma
Arch Dermatol
(1990)
Diagnostic accuracy and precision in assessing dermatologic disease: problem or promise?
Arch Dermatol
Evaluation of melanoma/skin cancer screening in Massachusetts: preliminary results
Cancer
Skin cancer screening focusing on melanoma yields more selective attendance
Arch Dermatol
Pitfalls in the diagnosis and treatment of melanoma
Arch Dermatol
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Supported by the Fund for Scientific Research-Flanders (Belgium) (F.W.O. G.0106.96).
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Reprint requests: Jean-Marie Naeyaert, Department of Dermatology, University Hospital Gent, De Pintelaan 185, 9000 Gent, Belgium.
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J Am Acad Dermatol 2001;44:979-86