Skin cancer medicine integral to Australian general practice

Skin cancer medicine is a core component of Australian general practice and is consistently in the top 10 conditions managed.1 This is not surprising as Australia has the highest incidence of melanoma in the world,2 leaving melanoma the fourth most common cancer in Australia, especially in non-metropolitan locations.3 Across the 20-year period 1995–2014, melanoma incidence in Queensland remained the highest recorded in the world (age-standardised incidence of invasive melanoma 572 per 100,000/annum [2010–2014]).4 Widespread public information campaigns have been effective; currently, approximately half of all new diagnoses of melanoma are initially noticed by the patient, who then approaches their clinician, usually their general practitioner (GP), for advice.5 This is leading to earlier detection, known to improve survival, with the incidence of in situ melanoma rising while the incidence of invasive melanoma is stable or falling in patients aged under 60 years.4 The management of melanoma continues to evolve, with the latest changes for both cutaneous and metastatic melanoma explored by Dixon et al.6,7 GPs are well positioned to play a key part in skin cancer medicine, with diagnostic acumen of similar high sensitivity and accuracy to formal skin cancer doctors.8 Overall management of skin cancer in general practice is of similar quality and effectiveness to that provided by skin cancer clinic networks.9 Similarly, despite patients with cutaneous melanoma having a high risk of recurrence and hence requiring careful follow-up, GP-led follow-up for melanoma has been shown to be as effective as hospital-based care.10