Genetic Factors Can Help Tailor Surveillance Programs for Melanoma

Surabhi Dangi-Garimella, PhD

A study conducted in Australia has concluded that a person’s inherited risk factors for melanoma should be considered when developing self-examination and surveillance programs.
With more than 10,000 deaths and 76,000 new diagnoses, melanoma is among the leading causes of cancer-related deaths, according to the American Cancer Society. New treatment options, particularly those that are immune-based, and early diagnosis could together go a long way in improving outcomes in this patient population. With this in mind, people at higher risk of melanoma are urged to consider having regular surveillance and be trained on self examination.
Authors of the present study, called "The Melanoma Patterns of Care" and published in JAMA Dermatology, aimed to characterize the clinical features in melanoma that are associated with a person’s risk for disease development; these include many nevi, prior history of melanoma, and family history of melanoma. The study enrolled 2727 patients with melanoma, who were diagnosed with an in situ or invasive primary melanoma, between October 2006 and October 2007.
A total of 1052 patients were identified as higher risk due to a family history of the disease, multiple primary melanomas, or many nevi. Compared with the low-risk patients (who did not have any of the risk factors), patients in the higher-risk group were younger when diagnosed (62 versus 65 years, P <.001). When specific risk factors were considered, however, the authors found that the age at diagnosis varied: it was 56 years for patients with a family history, 59 years for those with many nevi, and 69 years for those with a previous melanoma.
Further, among those at a higher risk, multiple nevi most likely meant they would have melanoma on the trunk region of their body (41% vs 29%, P <.001), a family history increased their likelihood of developing melanoma on the limbs (57% vs 42%, P <.001), while those with a history of melanoma were more likely to have melanoma on the head and neck (21% vs 15%, P  = .003).
Based on their findings, the authors concluded that education about self examination could be tailored to a person’s risk factors, such as highlighting areas on the body where melanoma is most likely to occur. The starting age for surveillance could also be tailored accordingly.
Watts CG, Madronio C, Morton RL. Clinical features associated with individuals at higher risk of melanoma: a population-based study [published online November 9, 2016]. JAMA Dermatol. doi:10.1001/jamadermatol.2016.3327.
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