Risk for second primary cancers increases significantly after melanoma
<<p>MedWire News: Melanoma survivors have a 9-fold increased risk for developing subsequent melanoma compared with the general population, report researchers in the Archives of Dermatology.
The team therefore recommends that “survivors should remain under surveillance not only for recurrence but also for future primary melanomas and other cancers.”
Porcia Bradford (National Institutes of Health, Rockville, Maryland, USA) and colleagues recruited 89,515 patients who were diagnosed with melanoma between 1973 and 2006 and who survived for at least 2 months after their initial diagnosis. They were followed-up for a median period of 9.2 years (maximum 34 years) for incidence of subsequent melanoma or other cancer.
The authors found that 10,857 (12.1%) of the participants developed one or more subsequent primary cancers.
The overall risk for subsequent primary cancer increased by 28% in those who survived beyond 2 months mainly due to subsequent primary melanoma, which accounted for 25% of the subsequent cancers recorded.
Risk for subsequent primary melanoma was highest between 2 months and 1 year after initial melanoma diagnosis (observed to expected rate [O:E]=16.94). However, even at 20 years after initial diagnosis there was an increased risk for subsequent melanoma compared with the general population (O:E=5.58).
In addition, those with initial melanoma on the head or neck were at increased risk for recurrence compared with people who had their initial lesion at another anatomical site (O:E=9.69), as were those under the age of 30 years (O:E=13.40).
Risk for other primary cancers was also increased in melanoma survivors, most commonly prostate cancer, female breast cancer, and non-Hodgkin lymphoma with an excess number of subsequent cancers per 10,000 person–years of 3.49, 1.34, and 1.18, respectively.
Bradford and team conclude: “Melanoma survivors are at an increased risk long after initial diagnosis for subsequent primary cancers, most likely owing to genetic susceptibility, behavioral risk factors, and increased medical surveillance.”
They suggest: “Patients who have been diagnosed with melanoma, therefore, should remain under continued surveillance not only for melanoma recurrence but also for new primary melanomas and other cancers.”
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By Helen Albert