Chloe Sowerby
Introduction:
Basal Cell Carcinoma (BCC) is one of the most common cancers in the UK, with an estimated incidence of approximately 75,000 cases diagnosed annually in primary care. The distinction between low-risk and high-risk BCC, which dictates management in either primary or secondary care, is based on histological features. Therefore, initial clinical diagnostic accuracy is critical to ensuring safe and effective management. The aim of this audit is to assess the safety and diagnostic accuracy of GP-led minor surgery (MS) for BCC.
Methods:
This is a community-based audit of GP minor surgery cases for suspected BCC, performed with the intention of excision. Data was collected from minor surgery clinics between August 2022 and July 2024 using EMIS records. Data included patient demographics, waiting times, excision margins, histology use, diagnostic accuracy, and complications.
Results:
A total of 49 excisions (22 males, 27 females, aged 51–95 years) were analysed. The mean waiting time was 9.9 weeks. Of the excisions, 30.6% were on the head/neck and 70.0% on the trunk/limbs, with none classified as high-risk. Complete excision was achieved in all histologically confirmed BCC cases (100.0%).
Complications were reported in 2 cases (4.1%), and histology samples were sent in all cases (100.0%), though 2 samples (4.0%) were lost in transit. Clinical diagnostic accuracy for BCC was 89.4%.
Conclusions:
GP minor surgery for BCC is safe, with high diagnostic accuracy and low complication rates. Further research is needed to refine NICE guidelines comparing primary and secondary care management.
Authors
Chloe Sowerby
Tameside and Glossop Integrated Care NHS FT, Greater Manchester, United Kingdom
Guy Wilkinson
Manor House Surgery, Glossop, United Kingdom