Risk Factors of Subsequent Primary Melanomas in Austria

Müller, Christoph; Wendt, Judith; Rauscher, Sabine; Sunder‐Plaßmann, Raute; Richtig, Erika; Faé, Ingrid; Fischer, Gottfried; Okamoto, Ichiro

doi:10.1001/jamadermatol.2018.4645

Cited by 20 publications

(51 citation statements)

References 43 publications

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“…Moreover, the authors noted that disentangling risk from use of sunbeds from that of the sun is difficult [anecdotal attribution of melanoma to sunbed use is often offset by excessive sunbathing, as exemplified by an Australian publicity campaign to regulate solaria (16)]. The importance of solar UV exposure and sunburn for melanoma development is reflected by the frequency of melanomas that occur after the diagnosis of a cutaneous melanoma, reported to range from 8.2% of previously diagnosed melanoma in European countries to 23% in countries with more intense ambient solar UV radiation (34)(35)(36)(37)(38)(39)(40)(41)(42). Earlier studies identified the number of sunburns as a good proxy of "at risk" sun exposure in relation to melanoma (17,18).…”

Section: Resultsmentioning

confidence: 99%

“…Suppa and Gandini mentioned the study, but the main findings were not adequately presented (1). In that study, solarium use was not associated with an increased but rather a reduced risk for developing melanoma (OR=0.71; 95% confidence interval=0.51-0.99; p=0.04) (34). Those findings indicate that solarium use may even have a protective effect.…”

Section: Inconsistent Findings Observed By Different Persons Differenmentioning

confidence: 86%

“…Unfortunately, however, the review of Suppa and Gandini (1) does not adequately consider those studies. For example, the retrospective case-control study of Müller and colleagues investigated risk factors for subsequent primary melanomas after the diagnosis of a cutaneous melanoma in Austria (1,648 participants with histologically verified cutaneous melanoma, including 1,349 with single and 299 with multiple primary melanomas) (34). Suppa and Gandini mentioned the study, but the main findings were not adequately presented (1).…”

Section: Inconsistent Findings Observed By Different Persons Differenmentioning

confidence: 99%

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Sunbeds and Melanoma Risk: Many Open Questions, Not Yet Time to Close the Debate

et al. 2019

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Background: Intensive scientific debate is ongoing about whether moderate solarium use increases melanoma risk. The authors of some recent publications demand the debate be closed and propose "actions against solarium use for skin cancer prevention" because new studies have convincingly demonstrated causality. This minireview aims to investigate whether those demands are sufficiently supported by present scientific knowledge and comply with the principles of evidencebased medicine. Materials and Methods: We performed a systematic literature search (through June 2019; PubMed, ISI Web of Science) to identify publications investigating how solarium use affects melanoma risk. Results: We found no studies that demonstrate a causal relationship between moderate solarium use and melanoma risk. Results of cohort and casecontrol studies published to date, including recent investigations, do not prove causality, and randomized controlled trials providing unequivocal proof are still lacking. Moreover, the overall quality of observational studies is low as a result of severe limitations (including unobserved or unrecorded confounding), possibly leading to bias. We also disagree with recent claims that Hill's criteria for the epidemiological evidence of a causal relationship between a potential causal factor and an observed effect are fulfilled in regard to the conclusion that moderate solarium use per se would increase melanoma risk Conclusion: Current scientific knowledge does not demonstrate a causal relationship between moderate solarium use and melanoma risk. Therefore, the debate is not closed. An intensive scientific debate is ongoing about whether solarium use increases melanoma risk (1-34). We previously published a meta-analysis of observational studies investigating the association of sunbed use with melanoma, concluding that no convincing evidence exists that moderate solarium use may increase melanoma risk (8). However, some recent publications (1-6) claim that new studies that show associations between solarium use and melanoma risk have convincingly demonstrated causality, and demand the debate be closed (1), and propose "actions against solarium use for skin cancer prevention" (1). In particular, Suppa and Gandini in their review address the following: a) New studies investigating the influence of age at first sunbed exposure on melanoma risk, b) novel association of sunbed exposure with risk of melanoma at different body sites, c) new data about the relevance of sunbed use for the development of additional primary melanomas, d) the most recent findings of how many melanomas are attributable to sunbed use, e) new data about the association of indoor tanning with melanoma risk factors, f) a recent analysis of 501 This article is freely accessible online.

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Section: Resultsmentioning

confidence: 99%

Section: Inconsistent Findings Observed By Different Persons Differenmentioning

confidence: 86%

Section: Inconsistent Findings Observed By Different Persons Differenmentioning

confidence: 99%

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Sunbeds and Melanoma Risk: Many Open Questions, Not Yet Time to Close the Debate

et al. 2019

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“…Family history comprises approximately 5-15% of melanoma cases; however, this does not imply that a single genetic mutation is being transmitted [4]; shared sun exposure and other risk factors are more plausible causes of melanoma among families with susceptible skin types [3]. Patients diagnosed with a single primary melanoma are at an increased risk of developing subsequent primary melanomas, which most likely occur within two years after the first diagnosis [5]. In fact, this has been demonstrated for 70% of melanoma patients who developed a second primary melanoma, showing the importance of close skin surveillance [6].…”

Section: Introductionmentioning

confidence: 99%

“…Non-melanoma skin cancer, other cancer types, gender, race, a higher number of nevi (especially dysplastic nevi), actinic skin damage, and family history of melanoma are all risk factors for hereditary melanoma [5,7]. Furthermore, hereditary melanoma has been associated with germline mutations in high-risk melanoma susceptibility genes (CDKN2A, CDK4, TERT, POT1) [8][9][10][11][12][13], polymorphisms in intermediate-risk melanoma susceptibility genes (BAP1, ACD, TERF2IP, MC1R and MITF) [14][15][16], and germline missense substitutions in MITF [17].…”

Section: Introductionmentioning

confidence: 99%

High-Throughput Sequencing Identifies 3 Novel Susceptibility Genes for Hereditary Melanoma

Campos¹,

Fragoso²,

Luís³

et al. 2020

Genes

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Cutaneous melanoma is one of the most aggressive human cancers due to its high invasiveness. Germline mutations in high-risk melanoma susceptibility genes have been associated with development hereditary melanoma; however, most genetic culprits remain elusive. To unravel novel susceptibility genes for hereditary melanoma, we performed whole exome sequencing (WES) on eight patients with multiple primary melanomas, high number of nevi, and negative for high and intermediate-risk germline mutations. Thirteen new potentially pathogenic variants were identified after bioinformatics analysis and validation. CDH23, ARHGEF40, and BRD9 were identified as the most promising susceptibility genes in hereditary melanoma. In silico analysis of CDH23 and ARHGEF40 variants provided clues for altered protein structure and function associated with the identified mutations. Then, we also evaluated the clinical value of CDH23, ARHGEF40, and BRD9 expression in sporadic melanoma by using the TCGA dataset (n = 461). No differences were observed in BRD9 expression between melanoma and normal skin samples, nor with melanoma stage, whereas ARHGEF40 was found overexpressed, and CDH23 was downregulated and its loss was associated with worse survival. Altogether, these results reveal three novel genes with clinical relevance in hereditary and sporadic melanoma.

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Efficiency of Detecting New Primary Melanoma Among Individuals Treated in a High-risk Clinic for Skin Surveillance

et al. 2021

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IMPORTANCEA previous single-center study observed fewer excisions, lower health care costs, thinner melanomas, and better quality of life when surveillance of high-risk patients was conducted in a melanoma dermatology clinic with a structured surveillance protocol involving full-body examinations every 6 months aided by total-body photography (TBP) and sequential digital dermoscopy imaging (SDDI).OBJECTIVE To examine longer-term sustainability and expansion of the surveillance program to numerous practices, including a primary care skin cancer clinic setting. DESIGN, SETTING, AND PARTICIPANTSThis prospective cohort study recruited 593 participants assessed from 2012 to 2018 as having very high risk of melanoma, with a median of 2.9 years of follow-up (interquartile range, 1.9-3.3 years), from 4 melanoma high-risk clinics (3 dermatology clinics and 1 primary care skin cancer clinic) in New South Wales, Australia. Data analyses were conducted from February to September 2020.EXPOSURES Six-month full-body examination with the aid of TBP and SDDI. For equivocal lesions, the clinician performed SDDI at 3 or 6 months. MAIN OUTCOMES AND MEASURESAll suspect monitored or excised lesions were recorded, and pathology reports obtained. Outcomes included the incidence and characteristics of new lesions and the association of diagnostic aids with rates of new melanoma detection. RESULTS Among 593 participants, 340 (57.3%) were men, and the median age at baseline was 58 years (interquartile range, 47-66 years). There were 1513 lesions excised during follow-up, including 171 primary melanomas. The overall benign to malignant excision ratio, including keratinocyte carcinomas, was 0.8:1.0; the benign melanocytic to melanoma excision ratio was 2.4:1.0; and the melanoma in situ to invasive melanoma ratio was 2.2:1.0. The excision ratios were similar across the 4 centers. The risk of developing a new melanoma was 9.0% annually in the first 2 years and increased with time, particularly for those with multiple primary melanomas. The thicker melanomas (>1-mm Breslow thickness; 7 of 171 melanomas [4.1%]) were mostly desmoplastic or nodular (4 of 7), self-detected (2 of 7), or clinician detected without the aid of TBP (3 of 7). Overall, new melanomas were most likely to be detected by a clinician with the aid of TBP (54 of 171 [31.6%]) followed by digital dermoscopy monitoring (50 of 171 [29.2%]). CONCLUSIONS AND RELEVANCEThe structured surveillance program for high-risk patients may be implemented at a larger scale given the present cohort study findings suggesting the sustainability and replication of results in numerous settings, including a primary care skin cancer clinic.

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Risk Factors of Subsequent Primary Melanomas in Austria

Abstract: on risk factors of subsequent melanomas would be helpful to identify patients at risk after the diagnosis of their first melanomas. OBJECTIVE To determine risk factors of subsequent melanomas.

Cited by 20 publications

References 43 publications

Sunbeds and Melanoma Risk: Many Open Questions, Not Yet Time to Close the Debate

Sunbeds and Melanoma Risk: Many Open Questions, Not Yet Time to Close the Debate

High-Throughput Sequencing Identifies 3 Novel Susceptibility Genes for Hereditary Melanoma

Efficiency of Detecting New Primary Melanoma Among Individuals Treated in a High-risk Clinic for Skin Surveillance

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