Skin cancer prevention, early detection, and management: Current beliefs and practices of Australian family physicians

The primary aim of this study was to examine Australian family physicians' beliefs and practices in relation to skin cancer prevention, early detection, and management. These factors were assessed by a mail-out survey, which was completed by 97 family physicians (69% return rate) randomly selected from the telephone book. Family physicians perceived that issues relating to the prevention and early detection of melanoma and other skin cancers were part of the role of family physicians. Furthermore, family physicians were rated as the most appropriate group for screening (100%; N = 94) and providing skin cancer education to the general public (96%; N = 93). Factors that discouraged family physicians from screening their patients included lack of time (32%; N = 31), forgetting (26%, N = 25), lack of financial incentive (20%; N = 19), and not being familiar with the patient's screening history (14%; N = 14). The family physicians sampled felt least confident in deciding whether changes are malignant (45%; N = 44), in diagnosing a melanoma (39%; N = 38), and in diagnosing a dysplastic nevus (33%; N = 32). While two-thirds of family physicians believed they currently detected 90 to 100% of their patients with melanoma, 93% felt that they should detect this proportion under ideal conditions, and 75% indicated that they should detect this proportion even given the existing constraints of their practice. The results indicate the need for formal training for family physicians in skin cancer prevention, early detection, and management issues, in order to bridge the gap between what family physicians believe they should be doing and their current practice.