Indian Journal of Dermatology
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Year : 2022  |  Volume : 67  |  Issue : 1  |  Page : 92

Risk factors for actinic keratoses: A systematic review and meta-analysis

1 Department of Dermatology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, District Baiyun, Guangzhou; Department of Dermatology, The Third People's Hospital of Shenzhen, District Longgang, Shenzhen, Guangdong, China
2 Department of Dermatology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, District Baiyun, Guangzhou, Guangdong, China
3 Department of Dermatology, Qingyuan Chronic Disease Prevention Hospital, District Qingcheng, Qingyuan, Guangdong, China

Correspondence Address:
Xushan Zha
Department of Dermatology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Jichang Road 16#, District Baiyun, Guangzhou 510 405, Guangdong
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijd.ijd_859_21

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Objective: To integrate evidence and assess the risk factors associated with actinic keratosis (AK). Methods: Unrestricted searches were conducted on five electronic databases, with an end-date parameter of September 2021. We summarized the study characteristics and pooled the results from individual studies by using a random-effects model. The risk of bias was estimated using the Cochrane Risk of Bias Tool, and the quality of evidence was estimated according to the Newcastle–Ottawa Scale. Results: Sixteen studies were included in final analysis, and we assessed the AK risk among a variety of risk factors. Overall, the male sex (odds ratio (OR): 2.51; 95% confidence interval (CI): 1.94–3.25; P < 0.01), age >45 years (OR = 7.65, 95% CI: 2.95–19.86; P < 0.01), light Fitzpatrick skin phototype (OR = 2.32, 95% CI: 1.74–3.10; P < 0.01), light hair color (OR = 2.17, 95% CI: 1.40–3.36; P < 0.01), light eye color (OR = 1.67, 95% CI: 1.03–2.70; P = 0.04), freckles on face/arms (OR = 1.88, 95% CI: 1.37–2.58; P < 0.01), suffered positive history of other types of non-melanoma skin cancer (OR = 4.46, 95% CI: 2.71–7.33; P < 0.01), sunburns in childhood (OR = 2.33, 95% CI: 1.47–3.70; P < 0.01) and adulthood (OR = 1.50, 95% CI: 1.12-2.00; P < 0.01), severe sunburn (OR = 1.94, 95% CI: 1.62–2.31; P < 0.01), and chronic occupational and/or recreational sun exposure (OR = 3.22, 95% CI: 2.16–4.81; P < 0.01) increased the risk of AK. Moreover, sunscreen use (OR = 0.51, 95% CI: 0.34–0.77; P < 0.01) and history of atopy reduced the risk of AK. Sensitivity analysis yielded consistent results. The included studies showed a high risk of bias. Conclusion: We confirm several well-known AK risk factors and their quantitative data, and summarized the uncommon risk factors and protective factors. Our results may inform on the design and implementation of AK screening and educational programs.

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