THE RECOGNITION AND MANAGEMENT OF MELANOMA AND OTHER SKIN-LESIONS BY GENERAL-PRACTITIONERS IN NEW-ZEALAND

Aim. To assess current levels of knowledge and management practices wi th respect to melanoma and other skin cancers, in a representative sam ple of New Zealand general practitioners. Methods. A self-administered questionnaire was sent to a random sample of 900 general practitioner s. The questionnaire included 12 cases with coloured photographs of sk in lesions and a brief presenting history. Responders were asked to as sess probable diagnosis, need for biopsy and management of the lesion. Other attitudinal and relevant background information was also gather ed. The questionnaire was sent to a comparison sample of 35 dermatolog ists. Results. The overall response rate was 66% among the general pra ctitioners and 68% among the dermatologists. The sample responding was representative of the larger population of doctors practising in New Zealand. Correct decisions whether or not to biopsy lesions (mean scor e of 10.1 out of 12) were significantly higher than the number of corr ect diagnoses (mean 8.4). Correct identification and recognition of th e need to biopsy melanomas was high. Diagnostic skills and recognition of the need for biopsy were somewhat lower among general practitioner s aged 50 years and over than among younger doctors. Doctors who had e xperience of a patient with melanoma had higher diagnostic skills and made more correct biopsy decisions. The general practitioners' scores for correct biopsy decisions were similar to those of the dermatologis ts sampled, although their diagnostic skills were somewhat lower, part icularly with respect to nonmelanoma skin cancers. Conclusion. The fin dings indicate a high level of expertise in terms of diagnosis of skin lesions and identification of need to biopsy suspicious lesions among general practitioners in this country.