GPs should routinely perform initial biopsies to test for melanoma, a new study claims.
Research found that patients who were given an initial diagnostic excision biopsy by their GP faced fewer subsequent hospital admissions and spent fewer days in hospital.
Around one in five melanoma cases in the UK is initially biopsied in primary care. But under current guidelines, any skin lesion seen that could potentially be a melanoma should be referred immediately to secondary care.
The researchers recommended that the UK should take inspiration from countries such as Australia, where initial diagnostic biopsies are routinely carried out by GPs.
Dr Peter Murchie and colleagues at the University of Aberdeen looked at data from 1,263 people on the Grampian melanoma database, the General Register Office for Scotland death registry, and the Scottish Morbidity Record.
They found there was no difference in mortality between the 262 patients who received their initial diagnostic excision biopsies in primary care and those who received them in secondary care.
Patients whose melanoma is first biopsied in primary care should be reassured that this does not reduce their chances of survival, the researchers wrote.
They claimed their findings, published in the British Journal of General Practice, indicate current guidelines might not offer patients the best opportunity of timely diagnosis and called for further research to establish the role of primary care in the treatment of cutaneous melanoma.
RCGP clinical champion for minor surgery Jonathan Botting welcomed the findings and said GPs were as capable of undertaking minor surgical procedures as their hospital colleagues.
He added: “In many ways the initial treatment of melanoma is the most straightforward surgery for any skin cancers. Peter Murchie’s paper demonstrates GPs can do this just as well as hospital doctors, and the long term outcomes appear to be cost effective.”
Dr Botting said diagnosis was the most difficult part of the initial management of melanoma.
He went on: “Improved diagnostic accuracy comes with training and experience. With the incidence of melanoma doubling every 10 years the NHS needs to support suitably skilled GPs being involved in melanoma management as part of an extended, community based, cancer network.”