Infrequent Follow-Up for Actinic Keratosis Treatment: A National Ambulatory Medical Care Survey.

OBJECTIVE

A nationally representative database was used to assess how soon patients were informed to return to clinic after cryosurgical treatment or prescription of topical 5-fluoruracil (5-FU) for actinic keratosis (AK).

METHODS

The National Ambulatory Medical Care Survey was used to capture diagnoses and medications associated with visits to U.S. outpatient physicians for the treatment of AKs between 2011-2016.

RESULTS

Patients treated with topical 5-FU were commonly told to return in two months or more (53%) or were not given a specific time to return at all (23%). Patients treated with cryosurgery were commonly told to return in two months or more (60%) or were not given a specific time to return at all (23%).

LIMITATIONS

This study was limited by the accuracy of AK diagnosis and treatment recording.

CONCLUSION

Adequate follow-up after cryosurgical or topical 5-FU treatment of AK allows physicians to assess response to treatment. When treatment for AKs fail due to lack of efficacy or intolerance, it is anticipated that patients may not return to clinic for long periods as return visits are scheduled months after cryosurgery or topical 5-FU is prescribed. Additionally, premature follow-up may not be adequate to ensure treatment-related inflammation has subsided. According to recently defined core outcome sets for AKs, if treatment fails due to intolerability, evaluation at 2 to 4 months could allow physicians to switch AK treatments. Follow-up 6 to 12 months post-treatment might better assess efficacy and potential reoccurrence of AKs.