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RESEARCH ARTICLE (Open Access)
Contents Vol 35(1)

Skin checks for potential skin cancers in general practice in Victoria, Australia: the upfront and downstream patterns and costs

David E Goldsbury A * , Damien McCarthy B , Caroline G Watts A C , Chi So D , Olivia Wawryk B , Chris Kearney B , Gillian Reyes-Marcelino A B , Kirstie McLoughlin A , Jon Emery B F and Anne E Cust A D
+ Author Affiliations
- Author Affiliations

A The Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia.

B Department of General Practice; Faculty of Medicine, Dentistry and Health Sciences; University of Melbourne; Victora, Australia.

C Kirby Institute, UNSW Sydney, Australia.

D Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, Australia.

E Melanoma Institute Australia, University of Sydney, NSW, Australia.

F Centre for Cancer Research; Faculty of Medicine, Dentistry and Health Sciences; University of Melbourne; Victoria, Australia.

* Correspondence to: David.Goldsbury@sydney.edu.au

Public Health Research and Practice 35, e34122406 https://doi.org/10.17061/phrp34122406
Submitted: 22 March 2024  Accepted: 8 April 2024  Published: 6 June 2024

2024 Goldsbury et al. This article is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Licence, which allows others to redistribute, adapt and share this work non-commercially provided they attribute the work and any adapted version of it is distributed under the same Creative Commons licence terms. See: www.creativecommons.org/licenses/by-nc-sa/4.0/

Abstract

Objectives

To describe patterns of skin checks for potential skin cancers in general practice and subsequent skin-related healthcare, and the associated costs.

Study type

Retrospective longitudinal health record linkage.

Methods

Patient encounters between 2010 and 2017 were extracted from clinical information systems at 73 general practice sites in Victoria, Australia, including Medicare billing information, from the MedicineInsight primary care dataset. The main outcomes were skin checks, skin-related healthcare up to 3 months after the skin check, and health system costs.

Results

There were 59 046 skin check encounters (0.7% of all general practice encounters) identified for 40 014 people with a median age of 52 years (interquartile range 36–67). Of these people, 26% had multiple skin checks. Of the subsequent skin checks, 28% were within 3 months of the initial skin check and 15% were after > 2 years. There was subsequent skin-related healthcare ≤ 3 months after 20% of all skin checks: 8% had a skin biopsy, 11% had a skin excision (of which 2% indicated a melanoma diagnosis, 29% keratinocyte carcinoma and 68% benign or other skin lesion), 2% had skin-related medicine prescribed and 5% had other skin-related treatment such as cryotherapy (not mutually exclusive). Ninety per cent of skin checks were billed as general practitioner (GP) consultations, including 65% as GP consultations of < 20 minutes although the proportion of longer consultations increased over time. The mean 3-month skin-related general practice health system costs for people without and with subsequent skin-related healthcare were A$58 and A$240, respectively, and up to a mean of A$595 for those having a melanoma excised.

Conclusions

Skin checks for potential skin cancers occur frequently in Australian general practice and accumulate substantial health system costs, with one in five skin checks resulting in subsequent treatment. This study adds to scarce real-world skin check and cost data in Australia.

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