Clustering of Cutaneous Melanoma in Health Care Workers of a Dermatological Day Hospital Unit

Abstract

Background: The incidence of cutaneous melanoma is increasing but in most countries is still below 20/100,000 per year. Despite such a low frequency of occurrence, recently the authors have had notice of several new melanoma cases among colleagues. We carried out a survey of melanoma occurrence among the personnel, and their close relatives, of a dermatological clinic. The self-reported figures were compared with data from cancer registries. Observations: Thirty-eight doctors and nurses were surveyed. Three responders reported having had a diagnosis of melanoma (7.9%, 95% CI 1.7-21.4%). The respondents reported having 617 ‘relatives who are alive today and would have come to them if they had a melanoma': 12 had known diagnoses of melanoma (1.9%, 95% CI 1.0-3.4%). The relative risks were 26.3 (95% CI 8.9-78.0) and 4.1 (95% CI 1.2-13.8) for doctors and nurses compared to the general population and to their relatives, respectively, and 6.5 (95% CI 3.7-11.4) for relatives compared to the general population. Conclusions: Two nonmutually exclusive hypotheses may be formulated to explain these findings: (a) most cutaneous melanomas regress spontaneously; (b) an infectious agent is involved in the causal pathway of cutaneous melanoma. Further studies may be warranted to confirm our observations and test such hypotheses.

Markedly reduced incidence of melanoma and nonmelanoma skin cancer in a nonconcurrent cohort of 10,040 patients with vitiligo

“…Such close surveillance could actually involve a relative tumors overestimation compared with a patient population not under dermatologic surveillance, as shown in a recent article reporting the increased incidence of melanoma among the medical and nursing staff of a dermatology ward. 30 Another relevant limitation of our study is the difference in age distribution of the 2 study groups, with patients seen for vascular surgery significantly older than patients with vitiligo. However, we wish to point out that the risk estimates in each age category consistently indicate a reduced risk for patients with vitiligo, both for melanoma and NMSC (Table I).…”