改善黑色素瘤筛查在初级保健:经验协会的法国全科医生执业皮肤镜。

IF 2.3 4区 医学 Q2 DERMATOLOGY
Julien Anriot, Nadia Ikhlef, Gérard Duru, Sophie Darnis, Pauline Scouarnec, Younes Tamarat, Mona Amini-Adle, Luc Thomas
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引用次数: 0

摘要

背景:黑色素瘤构成了日益加重的全球健康负担。鉴于一些国家皮肤科医生日益短缺,初级保健已成为皮肤癌筛查的最佳场所。从历史上看,法国的皮肤癌检测通常由皮肤科医生管理,而全科医生(gp)几乎没有参与。2021年,法国全科医生执业皮肤镜协会成立,旨在通过促进初级保健医生的皮肤镜检查实践并使其合法化来解决这一差距。目的:评估协会成立三年后经过皮肤镜训练的全科医生检测到的黑色素瘤数量,并将黑色素瘤的组织病理学特征与现有文献中的记录进行比较。方法:在2024年11月26日至2024年12月26日期间,通过谷歌®表单与协会Facebook®帐户的所有成员共享调查。结果:共有85名全科医生参与调查。他们报告了266例黑色素瘤的检测,相当于每年皮肤镜检查的中位数约为1.6例(平均值:2.9例)。在检测到的黑色素瘤中,39.5%(105/266)是原位的,而只有22.4%(36/161)的Breslow厚度大于1mm,与之前报道的gps检测到的黑色素瘤数据相比,这是一个实质性的改善。结论:通过皮肤镜检查学习来增强初级保健医学的能力似乎是一种有希望的方法,可以克服在一些国家观察到的诊断服务相对短缺的问题。将皮肤癌筛查纳入全科医生的实践可能有助于早期发现黑色素瘤,并支持降低黑色素瘤死亡率的持续努力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Improving Melanoma Screening in Primary Care: The Experience of the Association of French General Practitioners Practicing Dermoscopy.

Background: Melanoma constitutes an increasing global health burden. In the light of a growing shortage of dermatologists in several countries, primary care has emerged as an optimal setting for skin cancer screening. Historically, skin cancer detection in France was typically managed by dermatologists, while general practitioners (GPs) were barely involved. In 2021, the Association of French GPs Practicing Dermoscopy was created to address this gap by promoting and legitimizing dermoscopy practice among primary care physicians.

Objectives: To assess the number of melanomas detected by dermoscopy-trained GPs three years after the association's foundation and to compare the melanomas' histopathological characteristics to those documented in the existing literature.

Methods: A survey was shared via Google® Forms with all the members of the association's Facebook ® account between 26 November 2024 and 26 December 2024.

Results: A total of 85 general practitioners responded to the survey. They reported the detection of 266 melanomas, corresponding to a median of approximately 1.6 per year of dermoscopy practice (mean: 2.9). Of the detected melanomas, 39.5% (105/266) were in situ, while only 22.4% (36/161) had a Breslow thickness above 1 mm, which constitutes a substantial improvement compared to previously reported data on GP-detected melanomas.

Conclusions: Empowerment of primary care medicine through dermoscopy learning appears to be a promising way to overcome the relative shortage of diagnostic offer observed in several countries. Integrating skin cancer screening into a GP's practice may contribute to early melanoma detection and support ongoing efforts to lower melanoma mortality.

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