Patients with cutaneous melanoma showed a 57% higher risk of developing subsequent cancers compared with the general population, according to a new study.
In the study, published in the Journal of the American Academy of Dermatology, investigators analyzed data from 283,435 patients with melanoma using the Surveillance, Epidemiology, and End Results (SEER) database from 2000 to 2020, with 46,091 (16.3%) developing one or more second primary malignancies.
The data revealed elevated risks for 12 different types of second primary cancers. Melanoma survivors demonstrated a more than ninefold increased risk of developing another cutaneous melanoma, followed by uveal melanoma, sarcomas, thyroid cancer, salivary gland cancers, chronic lymphocytic leukemia, brain/nervous system cancers, non-Hodgkin lymphoma, renal cancer, prostate cancer, multiple myeloma, and breast cancer.
Patients diagnosed with melanoma younger than 39 years showed the highest risk. Risk peaked within the first year folloeing diagnosis and persisted beyond 15 years.
Patients with melanomas thicker than 4.0 mm exhibited the highest risk of developing any second cancer. Female patients with thick melanomas showed a nearly 25-fold increased risk of developing a second melanoma. While localized and distant stages showed similar risks, both demonstrated lower risk compared with regional staged melanomas.
American Indian/Alaskan Natives and Asian/Pacific Islanders demonstrated higher second primary malignancy risks compared with White and Black patients. Head and neck melanomas corresponded with higher secondary cancer risks compared with other sites.
Male patients exhibited higher risks for renal, prostate, and brain/nervous system cancers; whereas female patients showed elevated risks for multiple myeloma and breast cancer. Male patients comprised 66% of patients who developed a second cancer.
The investigators noted potential mechanisms including exposure to carcinogenic factors and increased screening measures in patients with thicker melanomas.
The study included an additional 194,000 subjects compared with previous SEER analyses and introduced stratification by primary melanoma thickness, initial stage, and patient demographics. Mean follow-up time was 9.9 years.
The study excluded second primary malignancies diagnosed within 2 months of initial melanoma diagnosis and underwent statistical adjustment for false discovery rate.
The research received no external funding. One author reported serving as an advisory board member to Kyowa Kirin, Krystal Bio, and Helsinn.