Document Detail


Practice Trends in the Treatment of Actinic Keratosis in the United States: 0.5% Fluorouracil and Combination Cryotherapy plus Fluorouracil Are Underused despite Evidence of Benefit.
MedLine Citation:
PMID:  22513063     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background:Topical fluorouracil and cryotherapy are among the most commonly used treatments for actinic keratosis. Evidence shows that 0.5% fluorouracil has similar efficacy and is better tolerated than 5% fluorouracil. Evidence also shows that combination therapy with cryosurgery and fluorouracil is beneficial.Objective:To examine fluorouracil and cryotherapy use in the treatment of actinic keratosis.Methods:The National Ambulatory Medical Care Survey database was queried for visits for actinic keratosis. Visits were analyzed for patient demographics, provider specialty, and treatment regimens. Fluorouracil and cryotherapy use was analyzed over time.Results:Cryotherapy was the most commonly used treatment for actinic keratosis. Fluorouracil products were prescribed to 1.1 million patients (6.6%) between 2001 and 2008; of these, dermatologists prescribed 0.5% fluorouracil in 51.8% of cases and 5% fluorouracil in 38.9% of cases. Combination fluorouracil and cryotherapy was used for only 1.1% of actinic keratosis visits between 1993 and 2008 and was never used by nondermatologists.Conclusions:Despite evidence suggesting comparable efficacy, greater tolerability, and lower cost of 0.5% fluorouracil relative to 5% fluorouracil, 5% fluorouracil is used by dermatologists almost as often as 0.5% fluorouracil. Among nondermatologists, 5% fluorouracil is used exclusively. Combination therapy of fluorouracil and cryotherapy is underused despite evidence of its benefit.
Authors:
Thomas J Hagele; Michelle M Levender; Scott A Davis; Phillip M Williford; Steven R Feldman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cutaneous medicine and surgery     Volume:  16     ISSN:  1203-4754     ISO Abbreviation:  J Cutan Med Surg     Publication Date:    2012 Mar-Apr
Date Detail:
Created Date:  2012-04-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9614685     Medline TA:  J Cutan Med Surg     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  107-14     Citation Subset:  IM    
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