Skin cancer clinics under microscope

[Editor-in-Chief]

Skin cancer clinics under microscope

SOME skin cancer clinics are removing moles unnecessarily at a growing cost to an already over-burdened health system, specialists say.
Plastic surgeons and dermatologists say they are seeing patients treated at skin cancer clinics who have had non-dangerous moles removed, sometimes leaving unsightly scars, while others have had genuine melanomas missed.

But other medical professionals, including the head of the University of Queensland's medical school, David Wilkinson, say the concerns may stem from the age-old "GPs versus specialists" debate.

"At least some of this debate seems to be vested in professional self-interest, rather than a dispassionate consideration of what is best for the patient," they write in The Medical Journal of Australia.

Nevertheless, Professor Wilkinson, who works one day a week in a Skin Alert clinic, said improved training, standards, accreditation, auditing and research was needed to ensure skin cancer clinics provided optimal health results for patients.

While some skin cancer clinics advertise themselves as specialist centres, most doctors working in them are said to be GPs.

Australia has no regulations for skin cancer clinics to be accredited against defined standards.

"As skin cancer clinics are … not general practices, they cannot be accredited through the mechanisms that apply to Australian general practice," the journal says.

The authors want the Federal Government to set up a working party to examine how skin cancer clinics can best be accredited.

A separate article in the journal about non-melanoma skin cancer, based on a 2002 national survey of more than 57,000 people, estimated that almost two in 100 Australians were treated for basal cell and squamous cell carcinomas in that year.

Non-melanoma skin cancer is the most commonly diagnosed cancer in Australia, and the most expensive, costing more than $264 million for diagnosis and treatment in 2000-2001.

The Queensland Cancer Fund is part-way through a study of skin cancer clinics to assess their ability to diagnose skin cancer correctly.

Early research has found more people are turning to skin cancer clinics for detailed skin examinations rather than going to GPs.

Results presented to a recent cancer conference in Brisbane indicated that between 2000 and 2001, 70 per cent of study participants reported having their skin checked in the previous three years by their GP, compared with 10 per cent at a skin cancer clinic.


Source