Enhancing Skin Cancer Prevention in a Primary Care Setting

Introduction

Skin cancer remains the most common cancer in Australia, affecting thousands annually. The healthcare costs exceed A$1.68 billion each year. Primary prevention stands as the most cost-effective strategy to combat this issue. Due to Australia’s mainly outdoor culture, the country has a high exposure to incidental ultraviolet (UV) radiation. Since 2004, the use of well accepted preventative measures, such as wearing sunscreen, have not improved. Recent research examined the current state of skin cancer prevention in primary care settings, as the first point of care for many patients.

Education and Training Programs for General Practitioners

Education and training for General Practitioners (GPs) are crucial in enhancing skin cancer prevention. Nine studies highlighted the importance of GP knowledge and training. One notable program, the Dermoscopy for Victorian General Practice Program, involved 130 GPs. Participants underwent online training, attended an eight-hour workshop, and received a dermatoscope. Post-training, 93% of GPs increased preventive information provision to high-risk patients, and 98.7% reported improved patient care quality.

Behavioural Counselling on Prevention

Behavioural counselling by GPs plays a significant role in skin cancer prevention. Five studies explored this aspect, including a Swedish randomised controlled trial with 309 participants. The study found that personalised preventive counselling and whole-body skin checks significantly improved sun protection behaviours. However, adherence to these behaviours decreased over time, highlighting the need for repeated interventions.

Novel Risk Assessment Tools

Risk assessment tools are becoming increasingly vital in primary care. Twelve publications examined melanoma risk assessment tools. These tools, such as those used in GP clinics via iPads, were found feasible and acceptable in Australia and the UK. However, variability in GPs’ ability to identify melanoma risk factors remains a challenge. Standardising these tools and their implementation could improve primary prevention outcomes.

New Technologies for Early Detection

Innovative technologies, including apps and teledermatology, are emerging as supportive tools for early detection and primary prevention. Five studies investigated these technologies, which were well-received by both patients and healthcare professionals. However, evidence on their cost-effectiveness is limited. Tools like the SunSmart Global UV app, supported by the World Health Organization, offer real-time UV level updates and sun protection reminders, illustrating the potential of digital interventions.

Barriers and Enablers in Primary Care

Identifying barriers and enablers is essential for effective implementation of skin cancer prevention activities. Key enablers include integrating prevention with routine clinical services, accessible risk assessment tools, and availability of guidelines. Barriers include limited consultation time, competing demands, and financial constraints. Addressing these challenges through streamlined processes and adequate resources can enhance primary prevention efforts.

Conclusion

This review underscores the need for comprehensive strategies to improve skin cancer prevention in primary care. Education, risk assessment tools, and new technologies show promise but require better integration and standardisation. Future research should focus on the feasibility and acceptability of these interventions within primary care models, ensuring they are tailored to diverse populations. Enhancing skin cancer prevention in primary care requires a multifaceted approach. By addressing barriers and leveraging enablers, we can improve patient outcomes and reduce the burden of skin cancer in Australia. Continuous education, innovative risk assessment tools, and new technologies are essential in achieving these goals.