Table 3.
Distribution of treatment modalities for actinic keratosis (AK) by general practitioners (GPs) and dermatologists using three different datasets
| Treatment by GP | Treatment by dermatologist | |||
|---|---|---|---|---|
| Routine GP records (IPCI) | RS | RS | Hospital claims data (DIS) | |
| GP records, first AK visit | GP records, all AK‐related visits | Dermatologist correspondence, all AK‐related visits | Claims for cutaneous premalignancies, first AK‐related visit | |
| Patients, n | 554a | 266b | 251b | 200 056 |
| Visits, n | 554 | 455 | 422 | 200 056 |
| No treatment (incl. no referral), n (%) | 42 (8) | 85 (19) | 52 (12) | 44 262 (22) |
| Referral, n (%) | 171 (31) | 67 (15) | N/A | N/A |
| Treatment by GP, n (%) | 341 (62) | 297 (65) | N/A | N/A |
| Treatment and subsequent referral | 41 (7) | 7 (2) | – | – |
| Treatment by GP only | 300 (54) | 290 (64) | – | – |
| Missing, n (%) | 0 (0) | 6 (1) | 6 (1) | 0 (0) |
| Type of treatment, n (%) | 341 (62) | 297 (65)c | 364 (86)c | 155 794 (78)d |
| Cryotherapy | 251 (74) | 239 (78) | 203 (56) | 64 047 (41) |
| Topical treatment of AKe | 23 (7) | 7 (2) | 76 (21) | 20 908 (13) |
| Photodynamic therapy | – | – | 19 (5) | 3150 (2) |
| Surgical | 28 (8) | 12 (4) | 43 (12) | 26 324 (17) |
| Other medical treatment of AKf | 38 (11) | 42 (14) | 22 (6) | 981 (1) |
| Otherg | 1 (0·3) | 5 (2) | 1 (0·3) | 40 384 (26) |
Different datasets are not comparable. When methyl aminolaevulinate cream is mentioned, this is not scored since the only indication for this treatment is as a primer for photodynamic therapy. DIS, DRG Information System; IPCI, Integrated Primary Care Information; N/A, not applicable; RS, Rotterdam Study.
aIn 554 of the 1000 patients included from the IPCI GP database, AK was in the differential diagnosis of the GP. bOf the 1322 participants screened in the RS, 266 had an AK‐related visit at the GP and 251 at the dermatologist. cTotal numbers add up to > 100% as patients may have received multiple treatments for their AK(s). dFor each AK‐related visit only the most invasive treatment was scored. eRelevant treatment of AK: 5‐fluorouracil, imiquimod and ingenol mebutate gel. For the hospital claims data this was only registered if patient picked up their prescribed treatment within 7 days after the outpatient clinic visit. fIncluded in other medical treatment of AK: nontopical treatment, tretinoin, salicylic acid, ureum, lanette, fucidine, cetomacrogol, diclofenac, antimycotic, antibacterial. gOther treatments are: laser, coagulation, unknown.