چکیده (انگلیسی):

Background:Skin cancer is believed to impose a heavy burden on healthcare services, but the burden of skin
lesions suspected of malignancy on primary healthcare has never been evaluated. Therefore the aim of this study
was to determine the demand for care in general practice due to these suspected skin lesions (i.e. lesions that are
suspected of malignancy by either the patient or the GP).
Methods:Registry study based on data (2001–2010) from the Registration Network Groningen. This is a general
practice registration network in the northern part of the Netherlands with an average annual population of
approximately 30,000 patients. All patient contacts are coded according to the International Classification of Primary
Care (ICPC). Consultations for skin lesions suspected of malignancy were selected according to the assigned ICPC
codes. Subsequently, the number of consultations per year and the annual percent change in number of contacts
(using the JoinPoint regression program) were calculated and analysed. Additionally, the percentage of patients
referred to secondary care or receiving minor surgery within one year after the first contact were calculated.
Results:From 2001 onwards we found an annual increase in demand for care due to skin lesions suspected of
malignancy of 7.3% (p < 0.01) and in 2010 the benign:malignant ratio was 10:1. In total 13.0% of the patients were
referred and after 2006, minor surgery was performed on 31.2% of the patients. Most surgeries and referrals took
place within 30 days.
Conclusions:Suspected skin lesions impose an increasing burden on primary healthcare and most likely on
healthcare costs as well. General practitioners should therefore be trained in diagnosing skin lesions suspected of
malignancy, as a high diagnostic accuracy can save lives in the case of melanoma, and may also prevent
unnecessary, costly, excisions and referrals to secondary healthcare.