Clinical Review

Skin in the game: epidemiology analysis of skin cancer in rural Western Victoria

AUTHORS

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Tori Dopheide
1 MD, BBiomedSc, Medical Student (Y4)

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Jessica Feeney
2 BSc (ParamedSc), BTrngDev, Medical Student (Y3) *

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Joshua Eaton
1 MD, BCOM

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Jessica Beattie
3 MHHSM, Lecturer in Rural General Practice (Program Development and Support) ORCID logo

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Rizwan Jaipurwala
3 FRACGP, Affiliate Lecturer ORCID logo

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Lara Fuller
3 FRACGP, Director of Rural Medical Education and Director Rural Community Clinical School ORCID logo

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Leesa Walker
4 FRACGP, Senior Lecturer

AFFILIATIONS

1 School of Medicine, Deakin University, Geelong, Vic. 3216, Australia

2 Oceania University of Medicine, Apia, Samoa

3 Rural Community Clinical School, School of Medicine, Deakin University, PO Box 713, Colac, Vic. 3250, Australia

4 Rural Health South Australia, Flinders University, PO Box 3570, Mount Gambier, SA 5290, Australia

ACCEPTED: 5 November 2024


early abstract:

Objectives: To evaluate the number and types of skin cancers excised by general practitioners in a rural clinic in South-West Victoria and analyse the number needed to treat and the influence of clinician experience on diagnostic accuracy. 
Design: A retrospective audit of patient records from two discrete time periods (14/10/2019–05/11/2020 and 01/02/2021–17/02/2022). Data extracted included number of lesions removed, location of lesions, skin cancers detected, patient and clinician demographics.
Results: A total of 789 lesions were excised, of these 449 (56.9%) were histologically confirmed to be malignant. Males were statistically more likely to be diagnosed with a malignancy (P=<.001). The number needed to treat for melanoma and non-melanoma skin cancer was 5.4 and 1.4, respectively. Experienced GPs (>5 years' experience) were better at detecting melanoma and non-melanoma skin cancer than their junior colleagues.
Conclusions: This study investigated the demographics of rural skin cancer patients and the diagnostic skills of GPs in South West Victoria. Results obtained found males had a higher risk of skin cancer than females. The diagnostic accuracy for all skin cancers improved with clinician experience and a lower overall number needed to treat for both melanoma and non-melanoma skin cancer when compared to existing literature. Differences in this may highlight the experience, exposure, and professional interest of rural GPs, addressing a lack of specialist services in the area.