Objective: To determine the policy of dermatologists practising in the Netherlands in the treatment of basal cell carcinoma.
Design: Written enquiry.
Setting: Catharina Hospital, Eindhoven, the Netherlands.
Method: All 293 dermatologists practising in the Netherlands were sent a questionnaire in May 1996 containing 15 questions about diagnosis and treatment of basal cell carcinoma.
Results: Eighteen forms dropped off because of termination of the practice or joint completion in group practices. The response was 76% (208/275). The diagnosis was made usually on the basis of histological examination (71% of the respondents; 84% in a tumour recurrence). Excision was the preferred treatment for all subtypes of basal cell carcinoma; second choices were cryosurgery or curettage/electrocoagulation. Roentgen contact therapy has been practically abandoned. New methods such as photodynamic therapy and immunotherapy are being used only sporadically on an experimental basis. Most dermatologists regarded tumour recurrences as a bigger problem than primary tumours. They attempt to reduce the percentage of recurrences by giving advice about risk factors (sunlight).
Conclusion: Too little use is being made of diagnostic biopsy to enable an optimal choice of therapy of basal cell carcinomas, especially in cases of recurrence tumours.