title: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: a Department of Dermatology , Center for Dermatology Research, Wake Forest School of Medicine , Winston-Salem , NC , USA .
authors.forename: Michael E
authors.initials: ME
authors.lastname: Farhangian
authors.affiliation: a Department of Dermatology , Center for Dermatology Research, Wake Forest School of Medicine , Winston-Salem , NC , USA .
authors.forename: Alyson
authors.initials: A
authors.lastname: Snyder
authors.affiliation: a Department of Dermatology , Center for Dermatology Research, Wake Forest School of Medicine , Winston-Salem , NC , USA .
authors.forename: Karen E
authors.initials: KE
authors.lastname: Huang
authors.affiliation: a Department of Dermatology , Center for Dermatology Research, Wake Forest School of Medicine , Winston-Salem , NC , USA .
authors.forename: Laura
authors.initials: L
authors.lastname: Doerfler
authors.affiliation: a Department of Dermatology , Center for Dermatology Research, Wake Forest School of Medicine , Winston-Salem , NC , USA .
authors.forename: William W
authors.initials: WW
authors.lastname: Huang
authors.affiliation: a Department of Dermatology , Center for Dermatology Research, Wake Forest School of Medicine , Winston-Salem , NC , USA .|b Department of Pathology , and.|c Department of Public Health Sciences , Wake Forest School of Medicine , Winston-Salem , NC , USA.
authors.forename: Steven R
authors.initials: SR
authors.lastname: Feldman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003452:Cryosurgery / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D055623:Keratosis, Actinic / Q000601:surgery*; D008875:Middle Aged; D012871:Skin Diseases / Q000601:surgery*; D014481:United States; D055815:Young Adult
keywords: Actinic keratosis; aging; cryotherapy; seborrheic keratosis; skin cancer; verruca; warts