Diagnosing skin cancer in primary care: how do main-stream general practitioners compare with primary care skin cancer clinic doctors?

Philippa H Youl, Peter D Baade, Monika Janda, Christopher B Del Mar, David C Whiteman and Joanne F Aitken
Med J Aust 2008; 188 (2): . || doi: 10.5694/j.1326-5377.2008.tb01546.x
Published online: 21 January 2008

In reply: We thank Heal and Raasch, and Keir for their comments and suggestions. First, as acknowledged in our article, it is possible that general practitioners with an interest in skin cancer may have been over-represented in our sample. It is also the case that the comparison between GPs and skin cancer clinic doctors may have been affected by characteristics of patients attending each type of practice. Patients attending skin cancer clinics are self-selected (often worried about a specific skin lesion), while for those attending GPs in mainstream practice, skin lesions are more likely mentioned during a consultation for something else.1 Case selection, which helps increase diagnostic ability by Bayesian principles (improving pretest probability of malignant lesions), may thus be more likely for skin cancer clinic doctors than GPs.2

  • 1 Viertel Centre for Research in Cancer Control, The Cancer Council Queensland, Brisbane, QLD.
  • 2 Institute of Health and Biomedical Innovation, Faculty of Health, Queensland University of Technology, Brisbane, QLD.
  • 3 Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD.
  • 4 Cancer and Population Study Group, Queensland Institute of Medical Research, Brisbane, QLD.


  • 1. Del Mar CB, Lowe JB. The skin cancer workload in Australian general practice. Aust Fam Physician 1997; 26 Suppl 1: S24-S27.
  • 2. Green A, Leslie D, Weedon D. Diagnosis of skin cancer in the general population: clinical accuracy in the Nambour survey. Med J Aust 1988; 148: 447-450.


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