Study: Melanoma survivors more likely to have new cancers

Melanoma skin cancer survivors are much more likely than the general population to have future new cases of invasive melanomas and other cancers, says a national study led by UAMS' Appathurai Balamurugan, M.D., M.P.H.

Published in the November issue of the Journal of American Academy of Dermatology, the study assessed the risk of new cancers among 116,922 melanoma survivors across the United States. The article can be found at www.eblue.org/article/S0190-9622(11)00612-8/fulltext.

The study was the first of its kind to estimate the risk of new cancers among people with in situ (noninvasive) melanoma using such a large sample size: 40,881 people. It found that even when diagnosed early, women melanoma survivors were 12 times more likely to develop invasive melanoma, and men survivors were eight times more likely.

Data for the study came from the National Cancer Institute Surveillance Epidemiology and End Results Program and involved an analysis of patient information from 1992 to 2006. Balamurugan, a family medicine resident at the Department of Family and Preventive Medicine in the UAMS College of Medicine, and an assistant professor in the Department of Epidemiology in the UAMS College of Public Health, was joined in the study by investigators from the national Centers for Disease Control and Prevention and the National Cancer Institute.

"The findings are significant, with an increased risk for future melanoma in both men and women survivors, and especially for women," Balamurugan said.

The higher incidence for women, he said, is probably a result of increased time spent outdoors and the use of tanning beds. He also said that while the average age for women being diagnosed with melanoma is the mid to late 50s, the deadly skin cancer is appearing in an increasing number of women in their 30s and 40s.

"It's quite alarming to see it shifting to younger and younger ages," Balamurugan said.

The stakes are high, he noted, because an estimated 70,230 people in the United States will be diagnosed with melanoma, and an estimated 8,760 people will die due to melanoma in 2011.

The study also analyzed the risk for future cancers in 76,041 people who survived invasive melanoma. Men were 12 times more likely to develop a new case of invasive melanoma and women were 15 times more likely.

In addition to the increased risk for future melanoma, these survivors also were much more likely to develop other cancers.

For survivors of an in situ (noninvasive early stage) melanoma, their risk of getting lymphocytic leukemia was 44 percent higher for men and 79 percent for women.

Men and women survivors of an invasive melanoma also were at higher risk for thyroid cancer (about twice as likely), non-Hodgkin's lymphoma (about 50 percent more likely) and chronic lymphocytic leukemia (about 60 percent).

Dan Knight, M.D., chairman of the Department of Family and Preventive Medicine, said he hopes the findings will lead to increased awareness among physicians and the general population.

"Ultimately we hope that physicians will more aggressively screen for melanoma," Knight said. "We can do a better job educating our patients about melanoma and helping them modify behaviors that will decrease their risk of developing melanoma."