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.
Keywords: Actinic keratosis; cryosurgery; field cancerization; field-directed therapy; follow-up visits; topical 5-fluorouracil.
Copyright © 2022. Matrix Medical Communications. All rights reserved.