Abstract
Purpose :
Individuals with BAP-1 mutations are predisposed to both cutaneous melanoma (CutM) and uveal melanoma (UM), and shared UV ray exposures between conjunctival melanoma (ConM) and CutM indicate common risk factors. These findings suggest shared risk factors between ocular melanomas and CutM that may also contribute to the risk of a second primary (sp) melanoma. We evaluated the risk of subsequent primary UM or ConM after diagnosis of a first primary (fp) CutM and the risk of subsequent CutM after diagnosis of a fp UM or ConM.
Methods :
We analyzed observational data from 17 registries of the Surveillance, Epidemiology, and End Results (SEER) Program from January 1, 2000 to December 31, 2020. Standardized incidence ratios (SIR), 95% confidence intervals (CI), and excess absolute risk (EAR) per 10,000 person-year were extracted and analyzed via single outcome analysis within the SEER software to assess the risk of sp CutM, UM, and ConM.
Results :
We identified 266,372 patients diagnosed with fp CutM, 7,512 patients with fp UM, and 523 patients with fp ConM. The mean age at diagnosis was 59.6 years for CutM, 60.9 years for UM, and 61.4 years for ConM. The majority of patients were non-Hispanic White (95.1%, 91.9%, and 82.2% for CutM, UM, and ConM, respectively). Among CutM patients, 55 developed sp UM on average 10 years later (SIR 1.8, CI 1.36-2.34, EAR 0.13), while 20 developed sp ConM on average 5.2 years later (SIR 8.58, CI 5.24-13.25, EAR 0.09). Among primary UM patients, 102 developed sp CutM on average 8.8 years later (SIR 2.83, CI 2.31-3.44, EAR 13.68). Among ConM patients, 19 developed sp CutM on average 10.6 years later (SIR 7.94, CI 4.78-12.4, EAR 46.83).
Conclusions :
This population-based cohort study found that patients with primary CutM had an increased risk of subsequently developing UM and ConM. Similarly, patients with primary UM and ConM had an increased risk of developing CutM. Notably, patients with ConM had a higher risk of developing CutM than those with UM, and patients with CutM had a higher risk of developing ConM than UM. This suggests a stronger link in etiology between CutM with ConM than with UM. These findings may underline the importance of regular skin screenings for patients with ConM and warrant more research on shared risk factors between these melanomas.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.