Risk of Subsequent Primary Tumor Development in Melanoma Patients

Abstract

Incidence of subsequent malignant tumor development in 740 patients with primary cutaneous melanoma verified between 2006 and 2010 at the Semmelweis University was studied retrospectively and was compared to data of sex and age matched Hungarian population. The follow-up period was 1499 person-years for the whole group from the diagnosis of index melanoma with an average of 2 years. Standardized incidence rate (SIR) was established as the ratio of observed and expected values. The risk of all subsequent malignancies was 15- and 10-fold higher in males (SIR: 15.42) and in females (SIR: 10.55) with melanoma, than in the general population. The increased cancer risk resulted mainly from the significantly higher skin tumor development: SIR values were 160.39 and 92.64 for additional invasive melanoma and 342.28 and 77.04 for subsequent in situ melanoma in males and females, respectively. Non-melanoma skin cancers also notably contributed to the higher risk, the SIR was elevated in both genders to the same extent (males: 17.12, females: 17.55). The risk was also significantly higher for extracutaneous tumor development like chronic lymphocytic leukemia, colon and kidney cancer (both genders), non-Hodgkin's lymphoma, cervical cancer (females), and bladder carcinoma (males). These data underline the importance of patient education and the necessity of frequent medical follow up, including a close-up dermatological screening of melanoma survivors for further malignancies.

Risks of different skin tumour combinations after a first melanoma, squamous cell carcinoma and basal cell carcinoma in Dutch population‐based cohorts: 1989–2009

“…These increased risks persist for more than 10 years after the first skin cancer diagnosis. Toth et al 16 20 reported a probability density model of a subsequent non-melanoma skin cancer and Asgari et al 19 reported crude incidence rates and hazard ratios of SCC with data of the Northern California Cancer Registry, but, in our opinion, relative risk or cumulative risk give more useful clinical information. The cumulative risks are in line with the averaged cumulative risks in the two meta-analyses (mean 20-year CR of a subsequent BCC or SCC in melanoma patients were, respectively, 14.0% and Risks of a different cutaneous malignancy 4.0%; mean 5-year CR of BCC after SCC was 39.3%; no 5-year CR was available for the other tumour combinations), but only 1 or 2 studies contributed to this meta-analyses.…”

“…The 95% CI was under Poisson distribution, and the statistical significance level was estimated at two-sided at 0.05. All analyses were performed using SAS 9.3 statistical software (SAS Institute, (4) 1246 (5) 961 (40) 1674 (50) 174 (5) 143 (6) 2,919 (14) 4,269 (20) 50-64 years 7361 (35) 7976 (27) 7165 (19) 4275 (16) 850 (35) 948 (28) 769 (22) 449 (20) 6990 (35) 6642 (31) 65-74 years 3646 (17) 3829 (13) 11 447 (30) 5870 (22) 418 (17) 401 (12) 1078 (31) 543 (24) 5963 ( (5) 2129 (8) 1181 (50) 941 (28) 217 (6) 232 (10) 3627 (18) 3,813 (18) Arms 3510 (16) 6201 (21) 5211 (14) 4807 (18) 364 (15) 727 (22) 537 (15) 453 (20) 1400 (7) 1392 (6) Legs 3431 (16) 11 464 (39) 1344 (4) 3531 (14) 396 (16) 1245 (37) 102 (3) 261 (11) 685…”

“…Recent studies 6,15-20 did not report risks over different follow-up periods, and no cumulative risks over time were reported. Toth et al 16 20 reported a probability density model of a subsequent non-melanoma skin cancer and Asgari et al 19 reported crude incidence rates and hazard ratios of SCC with data of the Northern California Cancer Registry, but, in our opinion, relative risk or cumulative risk give more useful clinical information. Using single-and multiple-failure models, Wehner et al 21 found that risks of new KC over time are substantially lower after a first lifetime KC diagnosis than after a non-first KC diagnosis.…”

Eleven Primary Melanomas, Colon Cancer, and Atypical Nevi in the Same Patient: A Case Report and Literature Review

“…Several studies confirm an increased risk of developing subsequent cancers, after a diagnosis of melanoma. The risk is estimated to be within 6–16% [ 5 – 8 , 11 , 35 , 36 ]. The risk is highest within the first year of diagnosis of melanoma [ 8 , 11 ] and is significantly higher for people with MPM compared to people with SPM [ 6 , 8 , 36 ].…”

“…The major risk factor for melanoma, exposure to solar radiation, is shared with patients with NMSC, but inversely associated with cancers like colorectal, prostate, and breast cancer. Other risk factors such as viruses (HPV) and immunosuppression are also discussed [ 6 , 35 , 36 ].…”