Increased Melanoma Risk in Parkinson Disease

Abstract

To evaluate the possible association of Parkinson disease (PD) and melanoma in North America. Design, Setting, and Patients: Thirty-one centers enrolled patients with idiopathic PD. At visit 1, a neurologist obtained a medical history. At visit 2, a dermatologist recorded melanoma risk factors, performed a whole-body examination, and performed a biopsy of lesions suggestive of melanoma for evaluation by a central dermatopathology laboratory. We compared overall prevalence of melanoma with prevalence calculated from the US Surveillance Epidemiology and End Results (SEER) cancer database and the American Academy of Dermatology skin cancer screening programs. Results: A total of 2106 patients (mean [SD] age, 68.6 [10.6] years; duration of PD, 7.1 [5.7] years) completed the study. Most (84.8%) had received levodopa. Dermatology examinations revealed 346 pigmented lesions; der-matopathological findings confirmed 20 in situ melanomas (0.9%) and 4 invasive melanomas (0.2%). In addition, histories revealed 68 prior melanomas (3.2%). Prevalence (5-year limited duration) of invasive malignant melanoma in the US cohort of patients with PD (n=1692) was 2.24-fold higher (95% confidence interval, 1.21-4.17) than expected in age-and sex-matched populations in the US SEER database. Age-or sex-adjusted relative risk of any melanoma for US patients was more than 7 times that expected from confirmed cases in American Academy of Dermatology skin cancer screening programs. Conclusions: Melanoma prevalence appears to be higher in patients with PD than in the general population. Despite difficulties in comparing other databases with this study population, the study supports increased melanoma screening in patients with PD.

Cancer in Parkinson’s disease

“…Of note, although a consistent pattern of increased melanoma occurrence was associated with PD and vice versa was seen across all 12 publications except the one by Fois et al [7], the aforementioned association between PD and melanoma was not statistically significant in most of the 12 studies included in this meta-analysis [22]. However, a higher relative risk for melanoma following PD diagnosis was also identified in four additional publications [4, 7, 9]. …”

“…In the study by Fois et al [7], the rate of cancer was adjusted for sex, age in 5 year bands, time period in single calendar years and district of residence. The risk of melanoma was also adjusted for age and sex in the study by Bertoni et al [4]. In the publication based on the Danish Cancer Registry each PD case was matched to four controls on sex, year of birth and survivorship [11, 12].…”

Inverse and Direct Cancer Comorbidity in People with Central Nervous System Disorders: A Meta-Analysis of Cancer Incidence in 577,013 Participants of 50 Observational Studies

“…Forty-three cohort studies were included, of which 8 had a prospective design and 35 had a retrospective design, and 8 were nested case-control studies. Three reports [7,23,24] contained data on cancer comorbidity in patients with AD, 11 in PD [25,26,27,28,29,30,31,32,33,34,35], 9 in MS [32,36,37,38,39,40,41,42,43], 2 in ALS [32,44], 19 in SCZ [45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63], 6 in DS [3,64,65,66,67,68], 2 in HD [69,70] and 1 in ASD [71]. Patient data were collected from population-based registries in 38 of the studies, of which 13 were hospital based.…”

Parkin regulates translesion DNA synthesis in response to UV radiation

“…PD patients are known to be more susceptible to melanoma [47–49]. Given that the frequency of Parkin mutations or deletions is relatively high in melanoma samples, and Parkin expression usually fails to be detected in melanoma-derived cell lines [8, 50], it is therefore tempting to speculate that Parkin might play an important role in cellular response to UV radiation.…”