Timely diagnosis of cutaneous squamous cell carcinoma: The GP's role

Background. Cutaneous squamous cell carcinoma (SCC) is the second most frequent skin cancer among Caucasians. Advanced cases determine significant tissue destruction and they can metastasize. Objectives. To evaluate the role of GPs in timely diagnosis of SCC, examining the probability of delay before the diagnosis and treatment of SCC among patients having first seen a GP compared to patients having accessed directly a dermatologist. Methods. We included a stratified sample of 308 SCC patients treated at a referral center in Italy. Medical records were reviewed and combined with patient interviews. Results. Multivariable analysis has shown that patients who have first seen a GP have a significantly lower likelihood of long patient delay [odds ratio (OR) = 0.45; 95% confidence interval (95% CI) 0.21-0.94; P = 0.04) compared to patients having accessed directly a dermatologist. Treatment delay was not associated with the specialization of the first doctor seen for the lesion (OR = 0.52; 95% CI 0.15-1.84; P = 0.31). Conclusion. Our findings highlight the potential role of the GP in facilitating rapid access to appropriate health care. © The Author 2010. Published by Oxford University Press. All rights reserved.