Prevalence of Actinic Keratosis and Its Risk Factors in the General Population: The Rotterdam Study

Limited data are available on the prevalence and risk factors of actinic keratoses (AKs). Within the Rotterdam Study, full-body skin examinations were performed among participants aged 45 years or older to estimate the age- and sex-standardized prevalence of AK and its associated risk factors. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for associations between risk factors and the presence of 1–3, 4–9, and ≥10 AKs. Of the 2,061 inspected cohort members (mean age 72 years), 21% had 1–3, 9% had 4–9, and 8% had ≥10 AKs. AK prevalence was 49% (95% CI: 46–52%) for men and 28% (26–31%) for women. Male gender, older age, light pigmentation status, severe baldness, skin wrinkling, and high tendency for sunburn were significantly associated with extensive actinic damage (≥10 AKs) in the multivariate analyses. Especially bald males were at an increased risk of severe actinic skin damage (adjusted OR=7.0 (3.8–13.1)). The prevalence of AK is very high, especially among elderly bald males. The prevention and management of AK is a true challenge for patients, physicians, and health-care policymakers.