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Gironi LC, Esposto E, Zottarelli F, Giorgione R, Farinelli P, Zavattaro E, Cammarata E, Di Cristo N, Ogliara P, Camillo L, Giordano M, Mellone S, Pasini B, Ambrosi A, Savoia P. Temporal correlation between the first melanoma and the first noncutaneous tumor in CKDN2A genotyped patients. Melanoma Res 2023; 33:425-430. [PMID: 37352544 DOI: 10.1097/cmr.0000000000000906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2023]
Abstract
CDKN2A pathogenic variants are well known to be associated with cutaneous melanoma and noncutaneous tumors (NCTs). Herein, we investigated the temporal correlation between the first cutaneous melanoma and NCT both in CDKN2A mutation carriers (MUT) and in wild-type melanoma patients, a poorly explored issue to date. Two hundred forty-five cutaneous melanoma patients were genotyped for the CDKN2A gene and divided into 51 MUT and 189 wild-type; the remaining five variant carriers were excluded from the analyses. MUT developed a significantly higher number of cutaneous melanoma than wild-type, while 13.7% in both genotyped groups received a diagnosis of at least one malignant NCT, without statistically significant differences. The onset of the first cutaneous melanoma preceded that of the first malignant or benign NCT in both MUT and wild-type patients by an average of 4.5 and 3.02 years, respectively. Considering only malignant tumors, the diagnosis of melanoma preceded that of the first NCT on an average of 8 and 4.34 years, in MUT and wild-type patients respectively. We emphasize the relevance to adopt a global vision for the primary and secondary surveillance of patients affected by cutaneous melanoma, not only limited to high-risk for multiple primary skin cancers but also to NCT that may develop several years after the diagnosis of the first cutaneous melanoma.
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Affiliation(s)
| | | | | | | | | | - Elisa Zavattaro
- Department of Health Sciences, University of Eastern Piedmont, Novara
| | | | - Nunzia Di Cristo
- Department of Health Sciences, University of Eastern Piedmont, Novara
| | - Paola Ogliara
- Department of Medical Sciences, University of Turin, Turin
| | - Lara Camillo
- Department of Health Sciences, University of Eastern Piedmont, Novara
| | - Mara Giordano
- Department of Health Sciences, University of Eastern Piedmont, Novara
- SCDU of Clinical Biochemistry, Laboratory of Genetics, AOU Maggiore della Carità, Novara
| | - Simona Mellone
- SCDU of Clinical Biochemistry, Laboratory of Genetics, AOU Maggiore della Carità, Novara
| | - Barbara Pasini
- Department of Medical Sciences, University of Turin, Turin
| | - Alessandro Ambrosi
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Paola Savoia
- Department of Health Sciences, University of Eastern Piedmont, Novara
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Słowińska M, Czarnecka I, Czarnecki R, Tatara P, Nasierowska-Guttmejer A, Lorent M, Cierniak S, Owczarek W. Clinical, Dermoscopic, and Histological Characteristics of Melanoma Patients According to the Age Groups: A Retrospective Observational Study. Life (Basel) 2023; 13:1369. [PMID: 37374151 DOI: 10.3390/life13061369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 05/27/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Although the role of melanoma risk factors is well documented, their correlation with patients' age is less frequently analyzed. METHOD The analysis was performed among 189 melanoma patients in different age groups, including <30 years, 31-60 years, and >60 years, to investigate the risk factors, topography, and coexistence of morphological features of 209 melanomas (dermoscopic and histopathological). RESULTS Among the youngest age group, no correlation with the presence of estimated risk factors was found. The most common dermoscopic pattern was spitzoid and multicomponent asymmetric. The group of middle-aged patients was the most diverse in terms of the occurrence of risk factors, solar lentiginosis, dermoscopic patterns, topography, histological subtypes, and invasiveness of melanomas. The oldest group characterized a strong correlation between solar lentiginosis, NMSC comorbidity, the prevalence of facial melanomas, the dermoscopic pattern of melanoma arising on chronic sun-damaged skin, and regression. CONCLUSION The findings regarding the presence of age-specific features in melanoma patients, especially in the youngest and middle-aged groups, might be helpful for clinicians and to target secondary prevention efforts.
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Affiliation(s)
- Monika Słowińska
- Department of Dermatology, Central Clinical Hospital Ministry of Defense, Military Institute of Medicine-National Research Institute, Szaserow 128, 04-141 Warsaw, Poland
- Evimed Medical Centre Ltd., Private Dermatologic Practice, JP Woronicza 16, 02-625 Warsaw, Poland
| | - Iwona Czarnecka
- Department of Dermatology, Central Clinical Hospital Ministry of Defense, Military Institute of Medicine-National Research Institute, Szaserow 128, 04-141 Warsaw, Poland
| | - Robert Czarnecki
- Department of Cardiology, LUX MED Oncology, Limited Liability Company, St. Elizabeth Hospital, Goszczynskiego 1, 02-616 Warsaw, Poland
| | - Paulina Tatara
- Department of Dermatology, Central Clinical Hospital Ministry of Defense, Military Institute of Medicine-National Research Institute, Szaserow 128, 04-141 Warsaw, Poland
| | - Anna Nasierowska-Guttmejer
- Department of Pathomorphology, Central Clinical Hospital of Ministry of Interior and Administration-National Medical Institute, Woloska 137, 02-507 Warsaw, Poland
- Faculty of Medicine, Lazarski University, Swieradowska 43, 02-662 Warsaw, Poland
| | - Małgorzata Lorent
- Department of Pathomorphology, Central Clinical Hospital Ministry of Defense, Military Institute of Medicine-National Research Institute, Szaserow 128, 04-141 Warsaw, Poland
| | - Szczepan Cierniak
- Department of Pathomorphology, Central Clinical Hospital Ministry of Defense, Military Institute of Medicine-National Research Institute, Szaserow 128, 04-141 Warsaw, Poland
| | - Witold Owczarek
- Department of Dermatology, Central Clinical Hospital Ministry of Defense, Military Institute of Medicine-National Research Institute, Szaserow 128, 04-141 Warsaw, Poland
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Ricci F, Paradisi A, Fania L, Pallotta S, DI Lella G, Sobrino L, Panebianco A, Abeni D. High melanoma risk in non-melanoma skin cancer patients under age 40: a large retrospective cohort study. Ital J Dermatol Venerol 2019; 156:240-243. [PMID: 31042854 DOI: 10.23736/s2784-8671.19.06276-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Patients with a history of non-melanoma skin cancer (NMSC) are at increased risk for other primary cancers, in particular for cutaneous melanoma. However, rarely such studies are able to identify age-specific risks due to the lack of statistical power. The aim of this study was to compare the risk of melanoma development within age groups in a large cohort of NMSC patients and in a control group of non-dermatological patients. METHODS A retrospective linkage analysis was performed between records of hospitalizations and the occurrence of melanoma was compared within 10-year age group by computing the relative risk (RR) and modeled using multiple logistic regression. RESULTS The linkage procedures identified 30,929 individuals with NMSC and 25,956 control patients. Overall, NMSC patients had RR for melanoma of 6.2 compared to controls. Patients with NMSC and less than 40 years of age have a RR of melanoma of 25.1 compared to controls. Our study is a retrospective analysis, and our ICD-9 codes do not distinguish between basal cell carcinoma and squamous cell carcinoma, nor between subtypes of melanoma. CONCLUSIONS Our large study suggests that prevention of melanoma in NMSC patients is mandatory, especially for patients which develop a NMSC under 40 years of age.
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Affiliation(s)
| | - Andrea Paradisi
- Unit of Dermatology, Cristo Re General Hospital, Rome, Italy
| | - Luca Fania
- First Dermatological Clinic, Istituto Dermopatico dell'Immacolata (IDI-IRCCS), Rome, Italy
| | - Sabatino Pallotta
- Fifth Dermatological Clinic, Istituto Dermopatico dell'Immacolata (IDI-IRCCS), Rome, Italy
| | - Giovanni DI Lella
- Unit of Day Surgery, Istituto Dermopatico dell'Immacolata (IDI-IRCCS), Rome, Italy
| | - Luciano Sobrino
- Hospital Information System, Istituto Dermopatico dell'Immacolata (IDI-IRCCS), Rome, Italy
| | | | - Damiano Abeni
- Unit of Clinical Epidemiology, IDI-IRCCS, Rome, Italy
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Körner A, Garland R, Czajkowska Z, Coroiu A, Khanna M. Supportive care needs and distress in patients with non-melanoma skin cancer: Nothing to worry about? Eur J Oncol Nurs 2015; 20:150-5. [PMID: 26236032 DOI: 10.1016/j.ejon.2015.07.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 06/16/2015] [Accepted: 07/13/2015] [Indexed: 01/15/2023]
Abstract
PURPOSE There is a paucity of psychosocial research on non-melanoma skin cancer (NMSC) despite the fact that these malignancies mainly develop on the head and neck, frequently recur, and are associated with an increased risk for other cancers. The current study aims to respond to this gap in the scholarship by determining the prevalence of supportive care needs and examining the relationship between patients' needs and distress. METHOD A cross-sectional research protocol included a consecutive sample of 60 patients with squamous and/or basal cell carcinomas who completed a survey comprised of the Skin Cancer Index (SCI), the Hospital Anxiety and Depression Scale (HADS), the Supportive Care Needs (SCNS) Survey, an inquiry about informational needs regarding skin cancer prevention, and a socio-demographic questionnaire. RESULTS More than half of the patients indicated unmet needs, most frequently endorsing moderate and high needs for help with: the prevention of future skin cancers, the health system and informational matters. Psychological needs were strongly associated with skin cancer-specific and general distress. Higher levels of anxious and depressive symptoms were related to greater patient needs across all domains. CONCLUSIONS Despite NMSC not being life threatening in most cases, there is a significant proportion of patients, who have unmet supportive care needs and experience heightened distress levels. This study raises awareness for health care professionals to be vigilant about the supportive care needs and the psychological health of patients with non-melanoma skin cancer.
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Affiliation(s)
- Annett Körner
- Department of Educational and Counselling Psychology, McGill University, 3700 McTavish Street, Suite 614, Montreal, Quebec, H3A 1Y2, Canada; Louise Granofsky Psychosocial Oncology Program, Segal Cancer Centre, Jewish General Hospital, 3755 Côte-Ste-Catherine Road, Montreal, Quebec, H3T 1E2, Canada; Psychosocial Oncology Program, McGill University Health Centre, 1650 Cedar Avenue, Montreal, Quebec, H3G 1A4, Canada; Department of Oncology, McGill University, 546 Pine Avenue West, Montreal, Quebec, H2W 1S6, Canada.
| | - Rosalind Garland
- Ingram School of Nursing, McGill University, Wilson Hall, 3506 University Street, Montreal, Quebec, H3A 2A7, Canada.
| | - Zofia Czajkowska
- Department of Educational and Counselling Psychology, McGill University, 3700 McTavish Street, Suite 614, Montreal, Quebec, H3A 1Y2, Canada.
| | - Adina Coroiu
- Department of Educational and Counselling Psychology, McGill University, 3700 McTavish Street, Suite 614, Montreal, Quebec, H3A 1Y2, Canada.
| | - Manish Khanna
- Department of Medicine, McGill University, 1650 Cedar Avenue, Room D6.237, Montreal, Quebec, H3G 1A4, Canada; Dermatology-Oncology Unit, Segal Cancer Centre, Jewish General Hospital, 3755 Côte-Ste-Catherine Road, Montreal, Quebec, H3T 1E2, Canada.
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Alberg AJ, Fischer AH. Is a personal history of nonmelanoma skin cancer associated with increased or decreased risk of other cancers? Cancer Epidemiol Biomarkers Prev 2015; 23:433-6. [PMID: 24609852 DOI: 10.1158/1055-9965.epi-13-1309] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Two conflicting hypotheses have been tested concerning the association between a personal history of nonmelanoma skin cancer (NMSC) and risk of other malignancies. One hypothesis is that as a marker of extensive sunlight exposure and hence vitamin D status, NMSC should be inversely associated with risk of other cancers. Alternatively, under the multiple primary cancer model, NMSC is postulated to be an informative first cancer to study as a marker of increased risk of subsequent primary cancer diagnoses. In this journal issue, Ong and colleagues report the results of a large-scale study in the United Kingdom with findings that NMSC was significantly associated with increased risk of a broad spectrum of other malignancies, with the associations stronger the younger the age of onset of NMSC. These results are consistent with the larger body of evidence on this topic, which is highly asymmetrical in favor of the multiple primary cancer hypothesis. Two divergent hypotheses have been tested, with the empirical evidence unequivocally indicating that NMSC is a marker of a high cancer risk phenotype. Future research is warranted to better characterize this association, to understand why NMSC is a marker of excess risk of other cancers, and to determine whether this association is clinically relevant.
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Affiliation(s)
- Anthony J Alberg
- Authors' Affiliations: Hollings Cancer Center and Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina; and Johns Hopkins University School of Medicine, Baltimore, Maryland
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Jung GW, Dover DC, Salopek TG. Risk of second primary malignancies following a diagnosis of cutaneous malignant melanoma or nonmelanoma skin cancer in Alberta, Canada from 1979 to 2009. Br J Dermatol 2014; 170:136-43. [PMID: 24443913 DOI: 10.1111/bjd.12694] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2013] [Indexed: 12/19/2022]
Abstract
BACKGROUND Recent studies have revealed geographical variations with respect to the risk of second primary malignancies (SPMs) following cutaneous malignant melanoma (CMM) and nonmelanoma skin cancer (NMSC). OBJECTIVES To provide the largest analysis of the risk of SPM following skin cancers in Canada and to detect associations that may shed light on common pathogeneses between linked malignancies. METHODS Relative risks for development of SPMs following a diagnosis of CMM or NMSC were calculated via a retrospective analysis of data retrieved from the Alberta Cancer Registry (ACR) from 1979 to 2009. RESULTS From 1979 to 2009, 85,967 NMSC and 6884 CMM incident cases were recorded in the ACR. In total 19,869 SPMs were identified following a primary NMSC (7709 cutaneous and 12,160 noncutaneous), while 1437 SPMs (908 cutaneous and 529 noncutaneous) followed CMM. Patients with a previous history of skin cancer had a 60% increased risk of developing an SPM compared with those without [observed/expected ratio (O/E) 1.6, 95% confidence interval (CI) 1.6-1.7; P < 0.001]. Thirty and 10 different SPMs were significantly identified to follow a diagnosis of NMSC and CMM, respectively. Patients under the age of 40 years with a prior history of CMM had a marked increased expectancy for SPM [O/E 5.6, 95% CI 4.5-7.0; P < 0.001). CONCLUSIONS Further studies are warranted to identify environmental and molecular connections among linked cutaneous and noncutaneous malignancies, which may lead to earlier detection of related neoplasms via expanded screening protocols and development of shared treatment regimens. Heightened surveillance for the development of SPMs in patients with CMM under the age of 40 years should be considered.
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Affiliation(s)
- G W Jung
- Division of Dermatology and Cutaneous Sciences, Department of Medicine, University of Alberta, Edmonton, AB, Canada
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