Seasonal and Geographic Trends in Photodynamic Therapy and Cryosurgery Use in the United States: A Cross-sectional...

Photodynamic therapy (PDT) is an effective field treatment for actinic keratoses (AKs). It is an ideal option for patients who prefer a minimally invasive procedure conveniently administered in their physician's office. Anecdotal clinician insights suggest that it may not be used at the same rate year-round.

This study investigates whether PDT and cryosurgery usage is affected by season and geographic location in the United States.

The data source is an aggregate of closed and open United States medical procedural claims (Common Procedural Code [CPT] and Healthcare Common Procedure Coding System [HCPCS]) from a broad selection of commercial payers and Centers for Medicare & Medicaid Services (CMS) from 2015 to 2022. Patient records associated with cryosurgery and PDT CPT codes were extracted. A total of 79.1 million patients from 50 states and 4 territories between 2015 to 2022 were included in the analysis. The data were further stratified using meteorologically defined seasons and geographic locations.

PDT utilization is affected by season and geographic location. Procedural claims peak during cooler months and decrease during warmer months, particularly where seasonal changes are more drastic. This trend repeats throughout the study period, including the COVID-19 pandemic. In contrast, use of cryosurgery remains unchanged.

The dataset does not capture claims from all commercial payers and CMS.

To our knowledge, this study provides the first evidence of PDT seasonal usage patterns across the nation. This pattern could be attributed to several factors and the findings could serve as a learning opportunity for clinicians to reevaluate their approach in treating AKs.