Cutaneous cryosurgery in the United States

Abstract

Background: Cryosurgery is a common treatment modality for many dermatological conditions; however, the extent to which it is used and by which medical specialties is not well characterized. Objective: To determine the rates of cryosurgery use over time, the top dermatoses treated by cryosurgery, patient demographics and the rate at which practitioners used cryosurgery. Methods: We used the National Ambulatory Medical Care Survey (NAMCS) from 1993 to 2010 in order to quantify the use of cryosurgery in outpatient offices. For visits where cryosurgery was utilized, the leading diagnoses, treating physician specialties, and patient ages were tabulated. Results: Cryosurgery was most commonly used for treating actinic keratoses (48% of visits), seborrheic keratoses (25% of visits) and verrucae (21% of visits). Dermatologists performed 82% of all cryosurgeries, followed by family/internal medicine physicians (13.6%) and pediatricians (2.8%). The use of cryosurgery for these dermatoses has increased over time (p < 0.0001), especially in patients over the age of 65 years. Physicians in offices with health maintenance organization-based practices were more likely to utilize cryosurgery. Limitations: Since NAMCS data are cross-sectional, we are unable to determine whether patients tried and failed other treatments. Conclusions: As the baby boomer generation ages, the demand for cryosurgery will likely further increase.

• Actinic keratosis
• aging
• cryotherapy
• seborrheic keratosis
• skin cancer
• verruca
• warts

Declaration of interest

The Center for Dermatology Research is supported by an unrestricted educational grant from Galderma Laboratories, L.P. Dr. Feldman is a speaker for Janssen and Taro. He is a consultant and speaker for Galderma, Stiefel/GlaxoSmithKline, Abbott Labs, Leo Pharma Inc. Dr. Feldman has received grants from Galderma, Janssen, Abbott Labs, Amgen, Stiefel/GlaxoSmithKline, Celgene and Anacor. He is a consultant for Amgen, Baxter, Caremark, Gerson Lehrman Group, Guidepoint Global, Hanall Pharmaceutical Co Ltd, Kikaku, Lilly, Merck & Co Inc, Merz Pharmaceuticals, Mylan, Novartis Pharmaceuticals, Pfizer Inc, Qurient, Suncare Research and Xenoport. He is on an advisory board for Pfizer Inc. Dr. Feldman is the founder and holds stock in Causa Research and is majority owner in Medical Quality Enhancement Corporation. He receives Royalties from UpToDate and Xlibris. Dr. Huang is a consultant for XOMA. He has conducted research studies for XOMA, Merz, Roche and Keranetics. He has been a speaker for XOMA and Galderma. All other authors have no conflicts to disclose.