Consultation circumstances leading to skin cancer detection in Australian general practice.

Introduction: General practitioners (GPs) diagnose and manage most skin cancers in Australia, often within time-limited consultations involving multimorbid patients. There is limited evidence describing the consultation circumstances in which skin cancers are detected.

Aim: This study aims to describe the most common consultation circumstances associated with skin cancer detection in Australian general practice.

Methods: We conducted a retrospective descriptive study across three general practices in Perth, Western Australia. In phase 1, we interviewed eight GPs to identify common consultation circumstances that lead to skin cancer detection and developed descriptive categories. In phase 2, we reviewed medical records of patients who had undergone skin cancer excision in the preceding 12 months, identified using Medicare item numbers. Consultation notes from the visit in which the lesion was identified were reviewed and classified using the phase 1 categories. We also recorded the number of problems managed per consultation.

Results: We reviewed 103 patient records from 210 eligible records. Most patients were aged over 60 years, and 73% had a documented history of skin cancer. Skin cancers were most commonly detected during multi-issue consultations addressing other health concerns (74.8%). Detection also occurred during general skin checks (21.4%), presentations for a single lesion (15.5%), and incidental findings during unrelated consultations (10.7%). GPs managed a mean of 2.90 problems per consultation. Percentages exceed 100% because more than one consultation category could apply to a single consultation.

Discussion: Skin cancer detection commonly occurs within complex consultations addressing multiple competing health issues, supporting opportunistic assessment and risk-based follow-up in general practice.