Nearly three in 10 Medicare beneficiaries have at least one actinic keratosis diagnosis encounter over five years of follow-up, according to a research letter published online July 27 in JAMA Dermatology .

Lucy J. Navsaria, M.B.B.Ch., from University of Texas MD Anderson Cancer Center in Houston, and colleagues used Medicare claims data (2009 to 2018) to identify beneficiaries without Medicare Advantage coverage (fee-for-service only) but with continuous Parts A, B, and D coverage. The authors sought to examine incidences and treatment patterns associated with actinic keratosis.

The researchers found that 29.3 percent of beneficiaries had one or more actinic keratosis diagnosis encounters. Of 8.18 million actinic keratosis diagnosis encounters (mean of 5.59 per patient), most occurred with dermatologists (78.6 percent) and physician assistants or nurse practitioners (10.4 percent). Topical fluorouracil was used in 2.3 percent of encounters. The raw incidence rate of actinic keratosis diagnosis encounters with treatments was higher for men versus women and for White patients versus all other race and ethnicity groups.

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

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