Clinical Topics

Melanomas Associated With Internal Malignancy Risk

by U.S. Medicine

January 1, 2019

PALO ALTO, CA — Genetic and environmental risk factors have been associated with the development of multiple primary melanomas (MPM) but a new study questioned whether those patients might have increased predisposition to developing internal malignancies.

The report published in the Journal of the American Academy of Dermatology sought to identify the risk of subsequent malignancies in MPM patients.1

Researchers from the VA Palo Alto, CA, Health Care System and Stanford University Medical Center analyzed multiple primary standardized incidence ratios for patients with one or more, two or more and three or more primary melanomas (PM) in the SEER database from 1973-2014.

Ultimately, they identified 223,799 patients with one or more, 19,709 with two or more and 3,995 with three or more PM, and found that risks of subsequent internal malignancy increased with number of PM, with observed to expected (O/E) ratios of 0.99, 1.14, and 1.23 (p<0.05) for patients with at least one, two and three PM respectively.

The study team reported that Internal malignancy was higher in younger MPM patients and those with superficial spreading melanoma

Most frequent malignancies among MPM patients included breast, prostate, thyroid, soft tissue, brain, kidney, non-Hodgkin’s lymphoma, and chronic lymphocytic leukemia. Results indicated that risk of subsequent cutaneous melanoma increased with O/E ratios of 8.09, to 22.52, to 41.03 (p<0.05) respectively.

While limited by incomplete SEER information about pigmentation phenotypes, histology, and treatments, study authors concluded, “Patients with MPM have increased risk of subsequent internal and cutaneous malignancies and may benefit from tight adherence to age-specific cancer screening.”

1. Cai ED, Swetter SM, Sarin KY. Association of multiple primary melanomas with malignancy risk: a population-based analysis of the Surveillance, Epidemiology, and End Results Program database from 1973-2014. J Am Acad Dermatol. 2018 Oct 1. pii: S0190-9622(18)32637-9. doi: 10.1016/j.jaad.2018.09.027. [Epub ahead of print] PubMed PMID: 30287320.

Related Articles

Current Treatment Halves Cardiovascular Disease Risk in Hep C Patients

PITTSBURGH—In more good news for veterans who have received treatment for hepatitis C virus, VA researchers have found that treatment not only reduces the risk of complications from liver disease, it also dramatically reduces the... View Article

VA Models Allow Earlier Identification of HCV Patients at Risk of Progression

ANN ARBOR, MI—New prognostic models developed by VA researchers can help clinicians identify which patients who have or have had chronic hepatitis C virus infection will develop cirrhosis or hepatocellular carcinoma. While the VA has... View Article

U.S. Medicine Recommends

More From oncology


Surgical Staging Often Inadequate for Gallbladder Cancer

Guidelines frequently aren’t followed when it comes to radical cholecystectomy with regional lymphadenectomy for patients with T1b gallbladder cancer.


Use of Hospice During Treatment Has Limited VA Use

Unlike in most private sector settings, veterans with advanced cancer can receive hospice care concurrently with treatments such as radiation and chemotherapy.


Hypertension, MGUS Associated with Herbicide Exposure in Vietnam Veterans

Based on a new review, two conditions–one extremely common and the other rare–appear to be related to herbicide exposure during the Vietnam War era.


Detailed Medical History Crucial for Lung Disease Diagnosis

Both general medicine physicians and specialists can find interstitial lung disease (ILD) and pulmonary fibrosis confusing, according to a recent study.


Some RCC Risk Factors Can Be Modified

Obesity, hypertension and smoking are the three modifiable risk factors that could aggressively be targeted to reduce renal cell carcinoma, according to a new study.

Subscribe to U.S. Medicine Print Magazine

U.S. Medicine is mailed free each month to physicians, pharmacists, nurse practitioners, physician assistants and administrators working for Veterans Affairs, Department of Defense and U.S. Public Health Service.

Subscribe Now

Receive Our Email Newsletter

Stay informed about federal medical news, clinical updates and reports on government topics for the federal healthcare professional.

Sign Up