Increasing utilization of topical field directed treatment for actinic keratosis: analysis of the National Ambulatory Medical Care Survey from 1995-2019

This study analyzed visits for actinic keratoses (AK) in the National Ambulatory Medical Care Survey (1995–2019), excluding those with concurrent keratinocyte carcinoma or warts. Procedure codes identified destructive treatments, while topical 5-fluorouracil and imiquimod were used to define field-directed therapy (FDT). Weighted Rao-Scott χ² tests and one-way ANOVA compared treatment utilization across survey years, patient demographics, insurance, and provider specialties. The analysis included 70 million estimated visits derived from 3,463 unweighted records, revealing increased FDT use over time and differences by insurance type and patient age.