Increased Risk of Subsequent Primary Malignancies in Melanoma versus Non-Melanoma Skin Cancer Patients

This population-based cohort study performed utilizing the TriNetX database compares the risk of subsequent primary malignancies in patients diagnosed with melanoma or non-melanoma skin cancer, including basal cell carcinomas and squamous cell carcinomas. A case cohort was identified using ICD-10-CM codes for melanoma, basal cell carcinoma, and squamous cell carcinoma, as well as 11 of the most common primary malignancies as defined by the American Cancer Society. These included breast, prostate, lung, colorectal, bladder, non-Hodgkin’s lymphoma, kidney, uterine, leukemia, pancreas, and thyroid cancer.

A total of 130,526 melanoma patients and 130,526 non-melanoma skin cancer patients were identified after propensity score matching for demographics. The adjusted risk ratios revealed that melanoma patients had a significantly increased risk of developing breast, prostate, lung, kidney, pancreatic, and thyroid cancer compared to NMSC patients. No significant differences were found in the risk of developing colorectal cancer, prostate cancer, bladder cancer, non-Hodgkin’s lymphoma, or leukemia between the two groups.

Overall, this TriNetX database study underscores the importance of tailored cancer surveillance, particularly for breast, prostate, lung, kidney, pancreatic, and thyroid cancer in melanoma survivors. Future research should focus on exploring the mechanisms behind the differential cancer risks observed in this study and refining screening strategies for higher-risk populations.

本基于人群的队列研究，采用TriNetX数据库，旨在比较确诊为黑色素瘤或非黑色素瘤性皮肤癌（包括基底细胞癌和鳞状细胞癌）的患者发生后续原发性恶性肿瘤的风险。通过使用国际疾病分类第10版临床修正版（ICD-10-CM）代码识别黑色素瘤、基底细胞癌和鳞状细胞癌病例，以及根据美国癌症协会定义的11种最常见的原发性恶性肿瘤，构建了一个病例队列。这些恶性肿瘤包括乳腺癌、前列腺癌、肺癌、结直肠癌、膀胱癌、非霍奇金淋巴瘤、肾脏癌、子宫癌、白血病、胰腺癌和甲状腺癌。经过对人口统计学特征的倾向得分匹配后，共识别出130,526例黑色素瘤患者和130,526例非黑色素瘤性皮肤癌患者。调整后的风险比表明，与非黑色素瘤性皮肤癌患者相比，黑色素瘤患者发生乳腺癌、前列腺癌、肺癌、肾脏癌、胰腺癌和甲状腺癌的风险显著增加。两组之间在发生结直肠癌、前列腺癌、膀胱癌、非霍奇金淋巴瘤或白血病的风险方面没有发现显著差异。总体而言，这项基于TriNetX数据库的研究强调了针对癌症的个体化监测的重要性，特别是在黑色素瘤幸存者中针对乳腺癌、前列腺癌、肺癌、肾脏癌、胰腺癌和甲状腺癌的监测。未来的研究应着重于探讨本研究中观察到的不同癌症风险差异背后的机制，并优化针对高风险人群的筛查策略。