Australian general practitioners' attitudes and knowledge of sentinel lymph node biopsy in melanoma management

Caroline G Watts; Andrea L Smith; Sam Robinson; Chiao-Han (Sharon) Chang; Chris Goumas; Helen Schmid; John W Kelly; Angela M Hong; Richard A Scolyer; Georgina V Long; Andrew J Spillane; Michael Henderson; David E Gyorki; Victoria J Mar; Rachael L Morton; Robyn PM Saw; Alex H Varey; Graham J Mann; John F Thompson; Anne E Cust

doi:10.31128/AJGP-10-19-5138

Australian general practitioners' attitudes and knowledge of sentinel lymph node biopsy in melanoma management

Aust J Gen Pract. 2020 Jun;49(6):355-362. doi: 10.31128/AJGP-10-19-5138.

Authors

Caroline G Watts¹, Andrea L Smith², Sam Robinson³, Chiao-Han (Sharon) Chang⁴, Chris Goumas⁵, Helen Schmid⁶, John W Kelly⁷, Angela M Hong⁸, Richard A Scolyer⁹, Georgina V Long¹⁰, Andrew J Spillane¹¹, Michael Henderson¹², David E Gyorki¹³, Victoria J Mar¹⁴, Rachael L Morton¹⁵, Robyn PM Saw¹⁶, Alex H Varey¹⁷, Graham J Mann¹⁸, John F Thompson¹⁹, Anne E Cust²⁰

Affiliations

¹ MPH, PhD, Research Fellow, Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, NSW; Research Fellow, Surveillance, Evaluation and Research Program, Kirby Institute, UNSW, NSW.
² MPH, PhD, Research Fellow, Centre for Healthcare Resilience and Implementation Science (CHRIS), Australian Institute of Health Innovation (AIHI), Faculty of Medicine and Health Sciences, Macquarie University, NSW.
³ BAppPH, Research Officer, Cancer Epidemiology and Prevention Research, Sydney School of Public Health, University of Sydney, NSW.
⁴ MD, Research Assistant, Cancer Epidemiology and Prevention Research, Sydney School of Public Health, University of Sydney, NSW.
⁵ MPH, Biostatistician, Cancer Epidemiology and Prevention Research, Sydney School of Public Health, University of Sydney, NSW.
⁶ MPH, Co-ordinator, Melanoma Research Program, Westmead institute for Medical Research, NSW.
⁷ MD, Adjunct Professor, Monash University Department of Medicine at Alfred Health, Consultant Dermatologist, Victorian Melanoma Service, Melbourne, Vic.
⁸ MBBS, MMed, PhD, FRANZCR, Radiation Oncologist, Melanoma Institute Australia, Chris O'Brien Lifehouse, Mater Hospital North Sydney, NSW; Clinical Professor, Medicine, Central Clinical School, University of Sydney, NSW.
⁹ MD, Co-Medical Director, Melanoma Institute Australia, University of Sydney, Sydney, NSW; Clinical Professor, Discipline of Pathology, Faculty of Medicine and Health, University of Sydney, Sydney, NSW; Senior Staff Specialist in Anatomical Pathology, Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, NSW.
¹⁰ BSc, PhD, MBBS, FRACP, Co-Medical Director, Melanoma Institute Australia, Vic; Chair of Melanoma Medical Oncology and Translational Research, Melanoma Institute Australia and Royal North Shore Hospital, University of Sydney, NSW.
¹¹ MD, FRACS, Professor of Surgical Oncology, Northern Clinical School, School of Medicine, Faculty of Medicine and Health, University of Sydney, NSW; Surgical Oncologist, Royal North Shore and Mater Hospitals, North Sydney, NSW.
¹² MBBS, BMedSc, MD, FRACS, Professor of Surgery, University of Melbourne, Vic; Surgeon, Melanoma and Skin Service, Breast Service and Sarcoma Service, Peter MacCallum Cancer Centre, Vic.
¹³ MBBS, MD, FRACS, Consultant surgeon, Peter MacCallum Cancer Centre, Vic.
¹⁴ PhD, Director, Victorian Melanoma Service, Alfred Hospital, Melbourne, Vic; Adjunct Associate Professor, School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic.
¹⁵ MScMed, PhD (Clin Epi) (Hons), Director of Health Economics, NHMRC Clinical Trials Centre, Sydney Medical School, University of Sydney, NSW; Professor of Health Economics, Sydney Medical School, University of Sydney, NSW.
¹⁶ FRACS, MS, MBBS, Associate Professor in Surgery, Central Clinical School, University of Sydney, NSW; Surgical Oncologist, Melanoma Institute Australia, NSW; General Surgeon, Royal Prince Alfred Hospital, NSW.
¹⁷ BSc (Med), MBBS (Hons), FRACP, PhD, Medical Oncologist, Melanoma Institute Australia, Royal North Shore and Mater Hospitals, NSW; Associate Professor, Melanoma Medical Oncology, University of Sydney, NSW.
¹⁸ MBBS, PhD, FRACP, Director, John Curtin School of Medical Research, Australian National University, ACT; Principal Investigator, Melanoma Institute Australia, University of Sydney, NSW.
¹⁹ MD, Chairman, Australian Melanoma Clinical Practice Guidelines Working Party; Professor of Melanoma and Surgical Oncology, University of Sydney, Sydney, NSW; Surgeon, Royal Prince Alfred Hospital and Melanoma Institute Australia, Sydney, NSW. john.thompson@melanoma.org.au.
²⁰ MPH (Hons), PhD, Head of Cancer Epidemiology and Prevention Research Group, Sydney School of Public Health and Melanoma Institute Australia, University of Sydney, NSW; Professor of Cancer Epidemiology, Sydney Medical School, University of Sydney, NSW.

PMID: 32464734
DOI: 10.31128/AJGP-10-19-5138

Abstract

Background and objectives: In Australia, the uptake of the sentinel lymph node biopsy (SLNB) appears low despite clinical practice guideline recommendations. The aim of this study was to describe the knowledge and attitudes of general practitioners (GPs) to SLNB.

Method: GPs were recruited at an annual conference and a skin cancer skills workshop, and using GP professional communications. A mixed methods approach comprised a cross-sectional questionnaire and, for a subset of participants, semi-structured interviews.

Results: Overall, 231 GPs completed the questionnaire, of whom 23 were interviewed. One-third (32%) described themselves as quite or very familiar with the guidelines, and two-thirds (68%) thought that SLNB had an important role in the management of patients with melanoma. Of GPs who would discuss SLNB with eligible patients, <40% correctly identified that SLNB is recommended for patients with an invasive melanoma >1 mm thick.

Discussion: GPs were generally supportive of SLNB. Familiarity with the guidelines was low, particularly regarding which patients should be considered for SLNB.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Australia
Clinical Competence / standards
Clinical Competence / statistics & numerical data
Cross-Sectional Studies
Female
General Practitioners / standards*
General Practitioners / statistics & numerical data
Health Knowledge, Attitudes, Practice*
Humans
Male
Melanoma / therapy*
Middle Aged
Qualitative Research
Sentinel Lymph Node Biopsy / methods*
Surveys and Questionnaires