Skin cancer is by far the most frequent cancer worldwide. In Belgium it affects 1 in 5 adults before the age of 75. Based on our previous research, a high economic burden of skin cancer in Belgium resulted in a total cumulative cost of €107 million in 2014 that was projected to add up to €3.2 billion by 2034. Basal cell carcinomas represent 70% of all skin cancers. These are low-grade tumors that grow slowly and rarely metastasize. The incidence of basal cell carcinoma is projected to increase with 67% in the period of 2019-2030, especially in the older age groups. Since the vast majority of new basal cell carcinoma diagnoses are low-grade tumors in older people, many types of basal cell carcinoma could be monitored instead of treated. This concept, recently published by us, is ground-breaking in dermatology since all tumors are still treated to date. I will develop an integrated care-pathway for non-treatment followed by surveillance in older basal cell carcinoma patients, and research whether multi-criteria decision analysis can demonstrate its overall higher value compared to usual care. This project would lead to important optimization the dermato-oncological care from a patient’s perspective and possibly reduce low-value care, building on a strong research line already initiated by our group.