Helfand M, Gorman AK, Mahon S, Chan BK, Swanson N
Record ID 32002000420
This report aims to examine evidence about the natural history and management of actinic keratoses (AKs).
Authors' results and conclusions: The yearly rate of progression of an AK in an average-risk person in Australia is between 8 and 24 per 10,000. High-risk individuals with multiple AKs have progression rates as high as 12-30 percent over 3 years. Indirect evidence suggests that 2 percent of squamous cell cancers originating in AKs metastasize, and 7 percent recur locally. Over the course of a year, from 20-25 percent of AKs regress. There are no studies comparing the long-term efficacy or morbidity of topical treatment versus surgical treatment for AKs.
Authors' recomendations: Available data are insufficient to determine whether immediate treatment of all AKs, or a strategy of selective treatment for AKs that develop suspicious characteristics, result in different outcomes. An important information gap is how often squamous cell cancer metastasizes early in its course. The highest priorities for future research are controlled trials of different strategies for the long-term management of patients who have actinic keratoses; particularly multiple lesions; registry studies to assess morbidity and mortality related to squamous cell cancer in the elderly; and patient-centered research on patients preferences for, and quality of life related to, different treatments.
Authors' methods: Systematic review
Project Status: Completed
URL for project: http://www.cms.gov/coverage/8b3-t.asp
Year Published: 2001
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: United States
- Antineoplastic Agents
- Photosensitivity Disorders
- Precancerous Conditions
Organisation Name: Agency for Healthcare Research and Quality
Contact Address: Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;
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Copyright: Agency for Healthcare Research and Quality (AHRQ)
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