Basal cell carcinoma follow-up practices by dermatologists: a national survey.
BACKGROUND
After treatment of a basal cell carcinoma (BCC) patients are at risk of recurrence of that BCC; also, patients who have had a primary BCC are those who have an increased risk of developing a subsequent primary BCC. However, long-term hospital-based follow-up of all patients would put large strains on the U.K. health service.


OBJECTIVE
To investigate the follow-up intentions of U.K. dermatologists for well-defined facial BCC and to investigate the effect that variations in site and clinical indicators might have on those intentions.


METHODS
A self-completion questionnaire relating to BCC follow-up sent to 388 dermatology consultants and associate specialists in the U.K. had a response rate of 68%. The effects of treatment modality, tumour site, histology, multiple lesions and various patient variables that might alter the likelihood of follow-up were examined. General views on the subject of BCC follow-up were sought.


RESULTS
Twenty-seven per cent of respondents reported that they would not review further after excision of a 'well-defined' BCC from inside a central 'T' area on the face; 37% reported that they would review on one occasion; and 36% reported that they review more than once.


CONCLUSIONS
While it is currently not feasible to follow-up all treated BCCs, a strategy to identify and monitor high-risk patients and a system to gather long-term outcome data prospectively are necessary aspects of a national health service. This study illustrates that the first issue is being addressed to some extent, but at the currently reported level of BCC follow-up in the U.K. there is little scope for collecting comprehensive long-term data on outcomes.
Bower
C P
CP
Bristol Dermatology Centre, Bristol Royal Infirmary, UK. gif.bower@virgin.net
Lear
J T
JT
de Berker
D A
DA
D001291:Attitude of Health Personnel; D002280:Basal Cell Carcinoma / Q000473:pathology / Q000601:surgery*; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D005153:Facial Neoplasms / Q000473:pathology / Q000601:surgery*; D019538:Health Care Surveys; D006801:Humans; D007494:Ireland; D008134:Long-Term Care / Q000379:methods / Q000592:standards*; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012008:Recurrence; D012307:Risk Factors; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D011795:Surveys and Questionnaires; D006113:United Kingdom