Cancer Survivors Have Increased Risk of Cutaneous Melanoma



Patients with a previously diagnosed cancer have an increased risk of having cutaneous melanoma, with the highest risk among patients with prior diagnosis of melanoma, according to a report in the December issue of the Archives of Dermatology, one of the JAMA/Archives journals.

Cutaneous melanoma (CM) is one of the most aggressive forms of skin cancer. It is the fifth most commonly diagnosed cancer among U.S. men and the seventh most commonly diagnosed cancer among U.S. women. The incidence of CM is increasing and death rates from the disease have not significantly diminished, according to background information in the article. The greatest risk factor for CM development is UV radiation exposure, though this risk is affected by patients’ race and genetics.

Geoffrey B. Yang, B.S., a medical student at Case Western Reserve School of Medicine, Cleveland, Ohio, and colleagues analyzed data from the Surveillance, Epidemiology, and End Results database (1988-2007) to understand the risk of cutaneous melanoma following a previous cancer. The study included 70,819 patients with CM as a first primary cancer (median age of 54 years at the time of melanoma diagnosis) and 6,353 patients with CM (median age 70 years at the time of melanoma diagnosis) following a previous cancer.

The greatest number of melanomas developed among patients with a previous melanoma diagnosis – a finding consistent with other studies. Among patients younger than 45 years at first cancer diagnosis, 777 developed CM, with significantly higher risks among those with prior CM, other skin cancer, Kaposi sarcoma, female breast cancer and lymphoma. Patients 45 years of age or older at first cancer diagnosis had significantly higher risk of developing CM following prior CM, other skin cancers, ocular melanoma, female breast cancer, prostate cancer, lymphoma and leukemia.

“Characteristics associated with better survival in both cohorts included female sex, age younger than 45 years at melanoma diagnosis, being married, being white vs. black, decreasing Breslow depth [how deeply tumor cells have invaded], lack of tumor ulceration, no nodal involvement, and absence of metastases [the spread of cancer from the primary tumor to other locations in the body],” the authors write.

“Given that cutaneous melanoma is the most common second primary cancer in patients with a first CM (a risk that remains elevated for over 15 years), our results suggest the need for continued skin surveillance in melanoma survivors,” they conclude.

(Arch Dermatol. 2011;147[12]:1395-1402.