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Research project


High incidence rates of skin (pre)malignancies in many countries puts pressure on healthcare systems. Therefore, we described clinical practice in order to identify areas for improvement.

What we do

About our project

What is the motivation for this research? 

The incidence of actinic keratosis and keratinocyte cancer (KCs, consisting of basal cell carcinoma [BCC] and cutaneous squamous cell carcinoma [SCC]) is high and still rising. More than one third of patients with KC will develop at least one subsequent KC. Therefore, the economic burden of KC is substantial: KC ranks as the 5th most expensive cancer to treat among Medicare patients, among the highest per head in Australia and among the 5 most costly cancers in the Netherlands. Thus, optimal and efficient health care utilization is of vital importance to maintain a sustainable health care system.

What is the aim?

The aim of this study was to describe the diagnostic process, treatment and follow-up care of patients with actinic keratosis and keratinocyte cancer in primary and secondary care the Netherlands in order to identify opportunities to improve efficiency of care.

How will you perform this research?

Qualitative Research

Focus groups and in-depth interviews were conducted with both patients and health care providers in order to identify the needs and preferences of patients and barriers and facilitators among health care providers regarding skin cancer care.

Quantitative Research:

We conducted a multiple database study to described the diagnostic process, treatment patterns, and follow-up based on:

  • Primary care records of actinic keratosis from participants of the Rotterdam Study
  • Routinely collected primary care records (Integrated Primacy Care Information [IPCI]) of patients with (suspected) skin (pre)malignancies.
  • Netherlands Cancer Registry (NCR) data of patients with keratinocyte cancer.


Internal collaborations

Dept. Epidemiology: The Rotterdam Study

Dept. Medical Informatics: Integrated Primary Care Information

External collaborations

Netherlands Cancer Registry, www.iknl.nl


van Egmond S, Wakkee M, Droger M, Bastiaens MT, van Rengen A, de Roos KP, Nijsten T, Lugtenberg M.  Needs and preferences of patients regarding basal cell carcinoma and cutaneous squamous cell carcinoma care: a qualitative focus group study. Br J Dermatol. 2018 Jun 21. doi: 10.1111/bjd.16900. [Epub ahead of print]

Our team