Draft Wiki guidelines on BCC and SCC

ACCO commentary on draft Wiki guidelines

ACCO is very concerned about draft Australian wiki guidelines on BCC and SCC. As it stands ACCO recommends that members ignore the draft. We hope that a major rewrite might make this set of guidelines of value. At present some aspects of the draft guide promote skin cancer practice that is dangerous to the point of negligent. 

Our major concerns:

  1. PDT is listed as a treatment option for many skin cancers. This despite widespread data showing PDT has very poor clearance rates, large recurrence rates, immunosuppression problems and a large adverse event profile compared to other skin cancer management options. 
  2. Imiquimod is suggested as a treatment option for nodular BCC, even though the data shows very poor outcomes and our TGA does not permit this medication for this indication. Similarly, there is no TGA approval to use imiquimod to manage SCC in situ. 
  3. Radiation oncology is inappropriately listed as a treatment option for superficial BCC, SCC in situ and actinic keratoses.
  4. Curette and cryotherapy (C&C) along with curette and electrodessication (C&D) material is dated and hence recommendations do not align with current knowledge on these modalities.
  5. The references to keratoacanthoma are dated, and fail to recognise our current understanding of this condition and its management.

The full ACCO submission can be found here