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Actinic keratoses (AKs) are commonly diagnosed during dermatology visits and used to guide follow up care, such as skin cancer screening exams. However, prior research on AKs has focused on individual lesions: their rates of regression, recurrence, and progression to skin cancer. On a patient level rather than a lesion level, the risks and timing of skin cancers after a patient has had an AK have not been well studied, however. To evaluate this, we performed a cohort study using the OptumInsights Electronic Health Record Database between July 1, 2007 and June 30, 2017 among patients with AKs. We included 14,490 patients with at least one year of dermatology follow-up prior to their first AK in the cohort and no known history of basal cell carcinoma (BCC), squamous cell carcinoma (SCC), or melanoma. Mean follow-up was 2.0 years (SD 1.8 years). Using survival analysis, we calculated that the risk of a …