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An international team of researchers labeled actinic keratosis (AK) "a growing public health concern" after estimating its global prevalence at potentially more than 1 billion.

In the systematic review and meta-analysis, published in the , the incidence rate of AK was found to be 1,928 per 100,000 person years.

After analyzing 60 relevant papers, researchers uncovered that the global prevalence rate of AK was 14% (95% CI 14-15).

The analysis was led by physician-researchers with the department of dermatology at Erasmus MC Cancer Institute at the University Medical Center Rotterdam in The Netherlands. The following paper excerpts have been edited for length and clarity.

What was the context and impetus for this investigation?

There are no clear diagnostic criteria for AK, and studies show significant variation in prevalence estimates.

Previous studies have shown a high prevalence of AK in people aged >50 years and in certain countries, including The Netherlands and Australia. In other analyses, estimated prevalence rates in temperate and equatorial regions range from 11%-26%.

Better estimates of global prevalence, researchers wrote, can help local public health professionals determine the need for targeted prevention strategies.

The primary objective of the present study was to provide a comprehensive and updated analysis of global AK prevalence and incidence in the general population.

Investigators concluded that AK may be a growing public health problem, but also identified several major caveats. What were these underlying caveats?

Extrapolating the global AK prevalence rate determined in this study to an approximate world population of 8 billion would yield more than 1.1 billion individuals affected by AK.

However, this is most likely a significant overestimation, researchers concluded, given that the studies included in the meta-analysis were performed on predominantly non-Hispanic, white individuals.

According to the study team, the degree of heterogeneity in the included literature may also suggest that the prevalence of AK varies significantly by population and context. Thus, they advised caution when trying to apply the review's estimated global prevalence data to specific populations.

Finally, the prevalence of AK in populations with high ultraviolet radiation exposure was significantly higher than the global prevalence rate.

What are the take-home messages for dermatologists?

The analysis underscores the importance of effective preventive health campaigns and targeted interventions, particularly in high-risk groups and regions with a higher prevalence of AK.

Photoprotective behaviors, such as wearing sunscreen and sun-protective clothing, have been shown to reduce the burden of photocarcinogenesis. Additional measures to increase awareness may help in reducing risk.