The Role of General Practitioners in Actinic Keratosis Management in Europe: A Dermato-Oncologists Initiative

Background/Objectives: Actinic keratosis (AK) is the key precursor of invasive cutaneous squamous cell carcinoma (cSCC). Rising incidence, ageing populations, and limited dermatologists' availability, particularly in rural and underserved regions, underscore the need for more inclusive care pathways. As in other common diseases such as diabetes or hypertension, general practitioners (GPs) could play a pivotal role in improving access, early recognition, and management of AK, provided that systemic barriers are addressed. Methods: This article synthesises current evidence and expert insights from a European multi-country advisory process, focusing on Italy, France, Germany, Spain, Portugal, the Netherlands, and Greece. The advisory board comprised dermatologists selected based on their clinical expertise and national representativeness, and consensus was reached through structured discussion and iterative review of background materials. Results/Conclusions: The study outlines unmet needs, barriers, and enablers for GPs' involvement and proposes a structured strategy supported by consensus recommendations. It offers a pragmatic model for improving AK care through stronger collaboration between primary care and dermatology. Greater GPs' involvement may support earlier recognition, better triage, improved access to care, and more efficient use of specialist services, while ensuring that complex or high-risk lesions remain under dermatologists' oversight. This may help optimise AK care pathways across Europe.