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Full text AJCN pub

Authored by the American Heart Association and other medical associations

"The American Psychiatric Association (APA) practice guidelines are developed by expert work groups using an explicit methodology that includes rigorous review of available evidence, broad peer review of iterative drafts, and formal approval by the APA"

The frequency with which scientists fabricate and falsify data, or commit other forms of scientific misconduct is a matter of controversy... Misconduct was reported more frequently by medical/pharmacological researchers than others...This metareview is a conservative estimate of the true prevalence of scientific misconduct.

The estimate of overall treatment success for all treated patients at the end of follow-up was 77.9% (80.9% considering histology). The data support clinical assessment of initial response as predictive of long-term outcome. Most of the recurrences occurred early, indicating that careful follow-up is important during the first year after treatment.

Recurrence rate of superficial basal cell carcinoma following treatment with imiquimod 5% cream: conclusion of a 5-year long-term follow-up study in Europe. by Harald Gollnick

Eight of nine individuals, 89% (95% CI 56% to 97%) were histologically clear of sBCC at 52 weeks.

We found that 5% imiquimod cream is an effective treatment option for superficial and nodular basal cell carcinomas, giving a clearance rate of 89.5% at an average of 39 months of follow up.

Raasch B. Clinical, Cosmetic and Investigational Dermatology. 9 June 2009.  There is reasonable evidence that the use of imiquimod for small (<2 cm) superficial BCC that occur other than on the face provides  outcomes only marginally less satisfactory t

For patients without comorbidities, our study revealed good cure rates for superficial BCC and superficial/nodular BCC (88% and 85%, respectively). Nodular and aggressive BCC and Bowen's disease exhibited lower cure rates (50%, 50%, and 57%, respectively). I

There is reasonable evidence that the use of imiquimod for small (<2 cm) superficial BCC that occur other than on the face provides outcomes only marginally less satisfactory than surgery. There would be a place for imiquimod in treating patients with frequent multiple primary lesions when access to surgery is difficult or where clinical judgment may be influenced by patient factors as reported in some of the studies, eg, where patients may have contraindications to surgery.  It was noted that if recurrences occurred in this study they mostly occurred during the first 9 months after the end of treatment. The initial response was therefore predictive of long-term outcome so these authors recommend and encourage continued monitoring of skin lesions.

To date one long-term study indicates a treatment success rate of 78%-81% and that initial response is a predictor of long-term outcome. Recurrences tend to occur within the first year after treatment. Future research will compare this preparation to the gold standard treatment for superficial BCC - surgical excision.