Optimization of care for patients with superficial basal cell carcinoma

This thesis focuses on the optimization of care of a very common form of skin cancer: superficial basal cell carcinoma (sBCC). There are several treatment options for this superficial growing skin cancer. In order to help patients make a personalized treatment decision, a patient decision aid was developed and tested. First, we noticed that all patients had a low level of decisional conflict. This was not significantly lowered by using the decision aid nor was knowledge on treatment options increased. However, patients using the decision aid were more satisfied with their treatment decision afterwards compared to a control group that did not use the decision aid. Furthermore, cost-effectiveness of treatment was evaluated by a systematic literature review. From the few studies that were available, we concluded that, surgical treatment provides value for money compared to alternative treatments for sBCC and that imiquimod cream (a cream that clears tumour by a local immunological reaction) provides value for money compared to other non-surgical treatments.