The Care of Complex Skin Cancer in Rural New South Wales, Australia – Results of a Pilot Study of Primary Care Physicians

<sec><title>Background</title> Australia has the highest rates of keratinocyte cancer (KC). This represents a growing burden in the primary-care setting where the bulk of KCs are managed. Recent Complex KC (CKC) specialist treatment advances have led to improved outcomes, and multi-disciplinary team (MDT) case discussion. Do rural General Practitioners (GPs) have a clear pathway of referral so that their CKC patients can benefit? Given the paucity of literature about this we devised a pilot questionnaire and collated results. </sec><sec><title>Methods</title> Using a consensus from subject matter experts, a pilot questionnaire was devised to capture a clinician perspective of regionally-based New South Wales (NSW) GPs examining CKC patients and their management. The questionnaire was completed (i) in person at a conference and (ii) via email. Survey Monkey software was used to analyse results, which were reported using descriptive statistics. </sec><sec><title>Results</title> 65 people were contacted for this survey: 20 at a conference and 45 by email. The overall response rate was 20%. Eight (62%) respondents indicated that they had no established CKC referral pathway for their patients, patients experienced long waiting times (3 to 6 months) and had a long travel distance for care (200 + kms). Twelve (92%) respondents agreed that their patients did not have timely access to services and indicated their support for CKC MDT participation. There were a number of study limitations. </sec><sec><title>Conclusion</title> Despite limited data, there appear to be gaps in rural NSW GP CKC treatment pathways. More research is needed to understand the national landscape. </sec>