Abstract
Background
The rising incidence rates of skin cancer (SC) lead to an enormous burden on healthcare systems. General practitioners (GPs) might play an important part in SC care, but research has shown poor clinical recognition of SC, leading to a high rate of potentially unnecessary referrals.
Objectives
The aim of this study was to evaluate if a dermato‐oncological training programme (DOTP) for GPs improved their diagnostic skills and quality of referrals.
Methods
Out of 194 GPs in the Nijmegen area, 83 (42·8%) followed a DOTP on SC. Referrals from both a trained cohort (TC) and two cohorts of untrained GPs [untrained present cohort (UPC) and untrained historical cohort (UHC)] were included. Data on diagnostic skills, quality of referrals and the number of potentially unnecessary referrals were evaluated.
Results
A total number of 1662 referrals were analysed. The referral diagnosis was correct more often in the TC (70·3%) compared with the UPC (56·2%; P < 0·001) and the UHC (51·6%; P < 0·001). Furthermore, the TC also provided a better lesion description, mentioned a diagnosis more often in their referral letters and more often performed diagnostics before referral. In addition, fewer potentially unnecessary referrals were identified in the TC compared with the UPC (62·7% vs. 73·7%; P < 0·001) and the UHC (75·2%; P < 0·001).
Conclusions
GPs who followed a DOTP had better diagnostic skills and quality of referrals than untrained GPs, leading to fewer potentially unnecessary referrals. This might enhance a more efficient use of the limited capacity in secondary dermatological care and consequently lead to lower healthcare costs.
What is already known about this topic?
General practitioners (GPs) play an important part in skin cancer (SC) care and optimal recognition and referral are considered of vital importance to optimize SC care efficacy.
Previous research identified a rather poor clinical recognition of (pre)malignant skin tumours by GPs, leading to a high rate of potentially unnecessary referrals to dermatologists.
What does this study add?
GPs who followed a dedicated dermato‐oncological training programme had better diagnostic skills and quality of referrals than untrained GPs, leading to fewer potentially unnecessary referrals.
This might enhance a more efficient use of the limited capacity in secondary dermatological care and consequently lead to lower healthcare costs.
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