Multiple Primary Melanoma: Two-Year Results From a Population-Based Study | Dermatology | JAMA Dermatology | JAMA Network
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Beardmore  GLDavis  NC Multiple primary cutaneous melanomas.  Arch Dermatol 1975;111603- 609PubMedGoogle ScholarCrossref
Bhatia  SEstrada-Batres  LMaryon  TBogue  MChu  D Second primary tumors in patients with malignant melanoma.  Cancer 1999;862014- 2020PubMedGoogle ScholarCrossref
DiFronzo  LAWanek  LAElashoff  RMorton  DL Increased incidence of second primary melanoma in patients with a previous cutaneous melanoma.  Ann Surg Oncol 1999;6705- 711PubMedGoogle ScholarCrossref
Burden  ADNewell  JAndrew  NKavanagh  GConnor  JMMackie  RM Genetic and environmental influences in the development of multiple primary melanoma.  Arch Dermatol 1999;135261- 265PubMedGoogle ScholarCrossref
Giles  GStaples  MMcCredie  MCoates  M Multiple primary melanomas: an analysis of cancer registry data from Victoria and New South Wales.  Melanoma Res 1995;5433- 438PubMedGoogle ScholarCrossref
Goggins  WBTsao  H A population-based analysis of risk factors for a second primary melanoma among melanoma survivors.  Cancer 2003;97639- 643PubMedGoogle ScholarCrossref
Moseley  HSGiuliano  AEStorm  FKClark  WHRobinson  DSMorton  DL Multiple primary melanoma.  Cancer 1979;43939- 944PubMedGoogle ScholarCrossref
Marghoob  AASlade  JKopf  AWSalopek  TGRigel  DSBart  RS Risk of developing multiple primary cutaneous melanomas in patients with the classic atypical-mole syndrome.  Br J Dermatol 1996;135704- 711PubMedGoogle ScholarCrossref
Johnson  TMHamilton  TLowe  L Multiple primary melanomas.  J Am Acad Dermatol 1998;39422- 427PubMedGoogle ScholarCrossref
Ariyan  SPoo  W-JBolognia  JBuzaid  AAriyan  T Multiple primary melanomas: data and significance.  Plast Reconstr Surg 1995;961384- 1389PubMedGoogle ScholarCrossref
Wolff  JWollina  U Second malignancies in melanoma patients in Thuringia.  J Eur Acad Dermatol Venereol 2000;14479- 483PubMedGoogle ScholarCrossref
Stam-Posthuma  JJvan Duinen  CScheffer  EVink  JBergman  W Multiple primary melanomas.  J Am Acad Dermatol 2001;4422- 27PubMedGoogle ScholarCrossref
Kang  SBarnhill  RLMihn  MC  JrSober  AJ Multiple primary cutaneous melanoma.  Cancer 1992;701911- 1916PubMedGoogle ScholarCrossref
Slingluff  CLVollmer  RTSeigler  HF Multiple primary melanoma: incidence and risk factors in 283 patients.  Surgery 1993;113330- 339PubMedGoogle Scholar
Titus-Ernstoff  LDuray  PHErnstoff  MSBarnhill  RLHorn  PLKirkwood  JM Dysplastic nevi in association with multiple primary melanoma.  Cancer Res 1988;481016- 1018PubMedGoogle Scholar
Titus-Ernstoff  LPerry  AESpencer  SKGibson  JJCole  BFErnstoff  MS Pigmentary characteristics and moles in relation to melanoma risk.  Int J Cancer 2005;116144- 149PubMedGoogle ScholarCrossref
Nordlund  JJKirkwood  JForget  BM  et al.  Demographic study of clinically atypical (dysplastic) nevi in patients with melanoma and comparison subjects.  Cancer Res 1985;451855- 1861PubMedGoogle Scholar
Breslow  NEedDay  NEed Statistical Methods in Cancer Research Vol II: The Design and Analysis of Cohort Studies.  Lyon, France International Agency for Research on Cancer1987; IARC Scientific Publication No. 82 Google Scholar
Burden  ADVestey  JPSirel  JMAitchison  TCHunter  JAAMacKie  RM Multiple primary melanoma: risk factors and prognostic implications.  BMJ 1994;309375- 377PubMedGoogle ScholarCrossref
Savoia  PQuaglino  PVerrone  ABernengo  MG Multiple primary melanomas: analysis of 49 cases.  Melanoma Res 1998;8361- 366PubMedGoogle ScholarCrossref
Titus-Ernstoff  LErnstoff  MSKirkwood  JMBarnhill  RLFine  JDuray  PH Usefulness of frequent skin examination for the early detection of second primary cutaneous melanoma.  Cancer Detect Prev 1989;13317- 321PubMedGoogle Scholar
Blackwood  MAHolmes  RSynnestvedt  M  et al.  Multiple primary melanoma revisited.  Cancer 2002;942248- 2255PubMedGoogle ScholarCrossref
Berwick  MArmstrong  BKBen-Porat  L  et al.  Sun exposure and mortality from melanoma.  J Natl Cancer Inst 2005;97195- 199PubMedGoogle ScholarCrossref
Writing Group for the Women's Health Initiative Investigators, Risks and benefits of estrogen plus progestin in healthy postmenopausal women.  JAMA 2002;288321- 333PubMedGoogle ScholarCrossref
Shumaker  SALegault  CRapp  SR  et al.  Conjugated equine estrogens and incidence of probable dementia and mild cognitive impairment in postmenopausal women: Women's Health Initiative Memory Study.  JAMA 2004;2912947- 2958PubMedGoogle ScholarCrossref
April 2006

Multiple Primary Melanoma: Two-Year Results From a Population-Based Study

Author Affiliations

Author Affiliations: Department of Community and Family Medicine, Dartmouth Medical School, and the Norris Cotton Cancer Center (Drs Titus-Ernstoff and Cole and Mss Gibson and Ding), and Departments of Pathology (Dr Perry) and Medicine (Drs Spencer and Ernstoff), Dartmouth-Hitchcock Medical Center, Lebanon, NH.

Arch Dermatol. 2006;142(4):433-438. doi:10.1001/archderm.142.4.433

Objective  To assess the frequency of occurrence and risk factors for multiple primary melanoma.

Design  Population-based, case-control study.

Setting  New Hampshire.

Participants  Three-hundred fifty-four New Hampshire residents with a confirmed first diagnosis of cutaneous melanoma.

Main Outcome Measure  Diagnosis of a subsequent primary cutaneous melanoma.

Results  An additional melanoma occurred in 27 individuals (8%) within 2 years of their initial diagnosis, including 20 (6%) within the first postdiagnosis year. In 9 (33%) of these 27 cases, at least 1 subsequent melanoma was deeper than the first tumor. The 27 individuals with a subsequent melanoma diagnosis were classified as “cases” and were compared on the basis of risk factors to the 327 “controls” with a single melanoma diagnosis. The data indicate an inverse relation of risk of multiple primary melanomas with multiple blistering sunburns (P = .01 for the trend); the odds ratio (OR) was 0.32 (95% confidence interval [CI], 0.11-0.93) for 2 or more sunburns compared with none. The number of atypical moles was significantly related to increased risk (P = .004 for the trend). The presence of 3 or more atypical moles compared with none was associated with more than a 4-fold risk of multiple primary melanomas (OR, 4.29; 95% CI, 1.51-12.16).

Conclusions  Additional melanomas occur more frequently than previously shown. Our study confirms that atypical moles are strongly associated with risk of multiple primary melanomas but provides little evidence that risk is influenced by pigmentary characteristics, hours of sun exposure, or benign moles. The inverse association with blistering sunburn may reflect the influence of an unmeasured covariate.