Date of this Version
Background: Concern about skin cancer is a common reason for people from predominantly fair-skinned populations present to primary care doctors.
Objectives: To examine the frequency and body site distribution of malignant, pre-malignant and benign pigmented skin lesions excised in primary care.
Methods: This prospective study conducted in Queensland, Australia, included 154 primary care doctors. For all excised or biopsied lesions, doctors recorded the patient’s age and sex, body site, level of patient pressure to excise, and the clinical diagnosis. Histological confirmation was obtained through pathology laboratories.
Results: Of 9,650 skin lesions, 57.7% were excised in men and 75.0% excised in patients ≥ 50 years. The most common diagnoses were basal cell carcinoma (BCC) (35.1%) and squamous cell carcinoma (SCC) (19.7%). Compared to the whole body, highest densities for SCC, BCC and actinic keratoses were observed on chronically sun exposed areas of the body including the face in men and women, the scalp and ears in men, and the hands in women. The density of BCC was also high on intermittently or rarely exposed body sites. Women, younger patients and patients with melanocytic naevi were significantly more likely to exert moderate/high levels of pressure on the doctor to excise.
Conclusions: More than half excised lesions were skin cancer which mostly occurred on the more chronically sun exposed areas of the body. Information on the type and body site distribution of skin lesions can aid in diagnosis and planned management of skin cancer and other skin lesions commonly presented in primary care.