Actinic keratosis incidence rates remain high in older populations

Actinic keratosis remains a public health problem for older adults, occurring in approximately three of every 10 Medicare recipients, according to a research letter published in JAMA Dermatology.

“Actinic keratosis (AK) is common. However basic epidemiologic data on AK, such as incidence rates, are limited,” Lucy J. Navsaria, MBBCh, BAO, MPH, of the department of health services research at The University of Texas MD Anderson Cancer Center, and colleagues wrote.

A random sample of Medicare claims data of beneficiaries aged 65 years and older from 2009 through 2018 was obtained for this cohort study, which identified outpatient AK diagnoses. Using electronic health records, these data were validated and compared for demographic characteristics of patients with AK and those without AK.

The study found 29.3% of nearly 5 million patients had one or more AK diagnosis encounters and a raw incidence rate of 28,656 per 100,000 person years.

Diagnosis rates of AK with treatments was 23,466 per 100,000 person years.

Less than 5% of encounters had topical field treatments and less than 3% were treated with fluorouracil, which has recently been associated with decreased squamous cell carcinoma.

“Actinic keratosis is a major public health problem for U.S. older adults,” the authors wrote. “The findings demonstrated high incidence rates and suggested an opportunity for squamous cell carcinoma prevention through increased use of topical fluorouracil.”