Previous cancer diagnosis
significantly increases risk of developing 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,
lack of tumor ulceration, no nodal involvement, and absence of metastases,"
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.
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