皮肤癌及癌前期病变(包括AK)的发生率与日光暴露有关,其平均值已经由20世纪60年代的3%升高到了8%。[2]Berman B, Bienstock L, Kuritzky L, et al. Primary Care Education Consortium; Texas Academy of Family Physicians. Actinic keratoses: sequelae and treatments. Recommendations from a consensus panel. J Fam Pract. 2006;55(suppl):1-8.http://www.ncbi.nlm.nih.gov/pubmed/16672155?tool=bestpractice.com[9]Hemminki K, Zhang H, Czene K. Time trends and familial risks in squamous cell carcinoma of the skin. Arch Dermatol. 2003;139:885-889.http://archderm.jamanetwork.com/article.aspx?articleid=479412http://www.ncbi.nlm.nih.gov/pubmed/12873883?tool=bestpractice.com[10]Diepgen TL, Mahler V. The epidemiology of skin cancer. Br J Dermatol. 2002;146(suppl 61):1-6.http://www.ncbi.nlm.nih.gov/pubmed/11966724?tool=bestpractice.com[11]Christenson LJ, Borrowman TA, Vachon CM, et al. Incidence of basal cell and squamous cell carcinomas in a population younger than 40 years. JAMA. 2005;294:681-690.http://jama.jamanetwork.com/article.aspx?articleid=201373http://www.ncbi.nlm.nih.gov/pubmed/16091570?tool=bestpractice.com在温带北半球国家(如美国和英国),至少有一处AK皮损的成人比例较低(11%~26%),在靠近赤道的国家(如澳大利亚)其比例较高(40%~60%)。[2]Berman B, Bienstock L, Kuritzky L, et al. Primary Care Education Consortium; Texas Academy of Family Physicians. Actinic keratoses: sequelae and treatments. Recommendations from a consensus panel. J Fam Pract. 2006;55(suppl):1-8.http://www.ncbi.nlm.nih.gov/pubmed/16672155?tool=bestpractice.com[12]Anwar J, Wrone DA, Kimyai-Asadi A, et al. The development of actinic keratosis into invasive squamous cell carcinoma: evidence and evolving classification schemes. Clin Dermatol. 2004;22:189-196.http://www.ncbi.nlm.nih.gov/pubmed/15262304?tool=bestpractice.com
罹患AK的风险随着年龄增长而升高,30岁左右时患病率为10%,80岁以上时患病率大于90%。[4]Schwartz RA. The actinic keratosis. A perspective and update. Dermatol Surg. 1997;23:1009-1019.http://www.ncbi.nlm.nih.gov/pubmed/9391557?tool=bestpractice.com[13]Helfand M, Gorman AK, Mahon S, et al; US Department of Health and Human Services. Actinic keratoses: final report. May 2001. http://www.cms.gov/ (last accessed 26 September 2016).http://www.cms.gov/Medicare/Coverage/DeterminationProcess/downloads/id1TA.pdf患有特定遗传病(如常染色体隐性遗传的I型、II型白化病以及着色性干皮病)的人可能在较年轻时就罹患AK。[14]Lookingbill DP, Lookingbill GL, Leppard B. Actinic damage and skin cancer in albinos in northern Tanzania: findings in 164 patients enrolled in an outreach skin care program. J Am Acad Dermatol. 1995;32:653-658.http://www.ncbi.nlm.nih.gov/pubmed/7896957?tool=bestpractice.com[15]Lehmann AR, Bridges BA. Sunlight-induced cancer: some new aspects and implications of the xeroderma pigmentosum model. Br J Dermatol. 1990;122(suppl 35):115-119.http://www.ncbi.nlm.nih.gov/pubmed/2186779?tool=bestpractice.com[16]Lambert WC, Kuo HR, Lambert MW. Xeroderma pigmentosum. Dermatol Clin. 1995;13:169-209.http://www.ncbi.nlm.nih.gov/pubmed/7712643?tool=bestpractice.com[17]Luande J, Henschke CI, Mohammed N. The Tanzanian human albino skin. Natural history. Cancer. 1985;55:1823-1828.http://www.ncbi.nlm.nih.gov/pubmed/3978567?tool=bestpractice.com男性AK的患病率高于女性,无论是在美国(男女之比为26.5%比10.2%)、英国(男女之比为15%比6%),还是澳大利亚(男女之比为55%比37%)。[18]Memon AA, Tomenson JA, Bothwell J. Prevalence of solar damage and actinic keratosis in a Merseyside population. Br J Dermatol. 2000;142:1154-1159.http://www.ncbi.nlm.nih.gov/pubmed/10848739?tool=bestpractice.com[19]Zagula-Mally ZW, Rosenberg EW, Kashgarian M. Frequency of skin cancer and solar keratoses in a rural southern county as determined by population sampling. Cancer. 1974;34:345-349.http://www.ncbi.nlm.nih.gov/pubmed/4852096?tool=bestpractice.com[20]Frost C, Williams G, Green A. High incidence and regression rates of solar keratoses in a Queensland community. J Invest Dermatol. 2000;115:273-277.http://www.jidonline.org/article/S0022-202X(15)40956-X/fulltexthttp://www.ncbi.nlm.nih.gov/pubmed/10951246?tool=bestpractice.com浅肤色人群中AK的发生率是深肤色人群的6倍。[21]Green A, Beardmore G, Hart V, et al. Skin cancer in a Queensland population. J Am Acad Dermatol. 1988;19:1045-1052.http://www.ncbi.nlm.nih.gov/pubmed/3204179?tool=bestpractice.com