Reducing the incomplete excision of non melanotic skin cancers in Australian general practice.

AIM To develop a simple set of predictors of incomplete excision of non melanotic skin cancer and to test them prospectively. METHOD Possible predictors were identified by a literature review and modified by a retrospective analysis of histologically confirmed excisions by the author between 1992 and early 1998. The composite set was then tested prospectively on non melanotic skin cancer excisions from April 1998 to September 1999. RESULTS The set of predictors was used prospectively to identify lesions with which particular care should be taken to avoid incomplete excision. Using this method resulted in an overall reduction of incomplete excisions of about 50%. CONCLUSIONS The application of a set of predictors is an effective method of reducing incomplete excisions. A number of factors related to the age of the patient, the site of the lesion and its macroscopic appearance made up the set of predictors. Their application showed that particular care needs to be taken with lesions on the head and neck and lesions on patients who are under 50 years of age.