Treatment of basal cell carcinomas by general practitioners in Australia

Authors

  • Catherine L. Streeton MD, MAppEpid, FAFPHM,

    1. From the Health Economics Unit, Monash University, Austin Repatriation Medical Center, West Heidelberg, Melbourne, Victoria, Australia
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  • Elena Gospodarevskaya BA (Hons), PGDipBus, PGDipHE,

    1. From the Health Economics Unit, Monash University, Austin Repatriation Medical Center, West Heidelberg, Melbourne, Victoria, Australia
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  • Anthony Harris MA, MSc

    1. From the Health Economics Unit, Monash University, Austin Repatriation Medical Center, West Heidelberg, Melbourne, Victoria, Australia
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Catherine L. Streeton, md Health Economics Unit Monash University PO Box 82 East Melbourne Vic. 3002 Australia E-mail: streetonc@c031.aone.net.au

Abstract

Background  Basal cell carcinomas (BCCs) are a relatively common form of skin damage in Australians, involving approximately 1 in 200 general practice encounters per year.

Aim  To determine current treatments and the associated healthcare resource costs of BCC therapy in Australia.

Methods  A retrospective survey was undertaken relating to the treatment of patients presenting to their doctor with previously untreated BCCs. Data were collected from a sample of general practitioners who were asked to randomly select two BCC patients from their medical records and complete a questionnaire. Information about treatment types, number of doctor visits, treatment complications, and specialist referrals was extracted from the patient records.

Results  One hundred and sixty-four patients were recruited into the study (59% male), who were treated for a total of 244 BCCs (average of 1.5 lesions per patient). Twenty-two per cent of patients were referred to a specialist, most being referred to a general surgeon (45%) or plastic surgeon (25%). Excision was the preferred therapy; second choices were cryosurgery or curettage and cautery. Few adverse events were recorded. The typical number of doctor visits varied from 3.2 to 7.4, with a range of total cost per patient of AUS$146.60–496.20, depending on complexity and the need for referral.

Conclusion  With a reported incidence in Australia of approximately 788 per 100,000 persons, BCCs are not inexpensive to treat for such a relatively common condition.

Ancillary