Non-melanoma skin cancer guidelines for GPs ‘years away’

Dr David Buckley, Tralee GP and founder of the Solas Dermatology and Laser Clinic, said discussions on the guidelines had been ongoing for two-to-three years, but that the work is still in its “infancy”.

He estimated that due to the “huge volume of work” involved and the need to secure agreement from all stakeholders, it could be another two years before the guidelines are finalised.

Non-melanoma skin cancers represent a huge and increasing burden of work, which cannot continue to be managed solely in the hospital setting, Dr Buckley said.

Dr Buckley is public relations officer with the Primary Care Surgical Association (PCSA), which is holding it sixth scientific meeting and AGM in Kerry in September.

He said the PCSA “is working closely with the NCCP [National Cancer Control Programme] in drawing-up draft non-melanoma skin cancer guidelines for GPs at present and some of this work will be discussed at the meeting”.

“We’ve a huge incidence of skin cancer in Ireland; we’re one of the highest in Europe because of our pale skin and travelling on cheap holidays to southern Europe, more outdoor leisure and people living longer — there are all sorts of reasons.”

Non-melanoma skin cancers are less dangerous than melanoma skin cancers but are more numerous and still account for one-third of skin cancer deaths, Dr Buckley said.

The aim of the non-melanoma skin cancer guidelines for GPs is to establish a structure for the treatment of low-to-moderate risk non-melanoma skin cancers in the community.

Negotiations on developing draft guidelines are continuing, with the involvement of the ICGP, plastic surgeons, dermatologists, the IMO and NAGP. A fee structure for transferring cases to the community would need to be devised.

Private health insurers pay a “reasonable fee” for managing non-melanoma skin cancers in the community but the HSE provides “hardly anything”, Dr Buckley added. 

“There’s huge value for money if they can just understand that these procedures, in the majority of cases — certainly well over two-thirds — are low or moderate risk and can be managed in the community.”