Funding sources This study was funded by the Dutch Cancer Society (KWF). The increasing burden of second primary cancers in the Netherlands: trends in incidence, survival and causes-of-death since 1970 (EMCR 2008–4132).
EPIDEMIOLOGY AND HEALTH SERVICES RESEARCH
Risk of second primary in situ and invasive melanoma in a Dutch population-based cohort: 1989–2008
Article first published online: 26 NOV 2012
© 2012 The Authors. BJD © 2012 British Association of Dermatologists
British Journal of Dermatology
Volume 167, Issue 6, pages 1321–1330, December 2012
How to Cite
van der Leest, R.J.T., Liu, L., Coebergh, J.W.W., Neumann, H.A.M., Mooi, W.J., Nijsten, T. and de Vries, E. (2012), Risk of second primary in situ and invasive melanoma in a Dutch population-based cohort: 1989–2008. British Journal of Dermatology, 167: 1321–1330. doi: 10.1111/j.1365-2133.2012.11123.x
Conflicts of interest None declared.
- Issue published online: 26 NOV 2012
- Article first published online: 26 NOV 2012
- Accepted manuscript online: 3 JUL 2012 10:07AM EST
- Accepted for publication 20 June 2012
Background Patients with melanoma are at increased risk of developing a subsequent melanoma.
Objectives To estimate the risks of developing a second primary in situ or invasive cutaneous melanoma after a first melanoma, between 1989 and 2008.
Methods Patients were followed until diagnosis of a second melanoma, date of death or end of study. Cumulative risks, standardized incidence ratio (SIR, observed second melanomas divided by background age-, calendar- and sex-specific incidence rates of melanoma, as recorded in the Netherlands Cancer Registry) and absolute excess risk (AER, observed minus expected per 10 000 person-years) of second melanomas were calculated.
Results In total, 10 765 patients with in situ melanoma and 46 700 with invasive melanoma were included. The cumulative risks of a second invasive melanoma after a first in situ or invasive melanoma at 20 years of follow-up were 6·2% and 5·0%, respectively. The relative risk of developing any melanoma (in situ or invasive) after any first melanoma (measured as SIR) varied from 12·4-fold [invasive after invasive melanoma; 95% confidence interval (CI) = 11·6–13·2] to 26·4-fold (in situ after in situ melanoma; 95% CI = 22·6–30·7) increase compared with the general population. SIRs and AERs remained elevated up to 20 years after the first melanoma.
Conclusions This study shows significantly increased long-term risks (both relative and absolute) of developing a second invasive melanoma after a first melanoma (invasive and in situ), and might serve as a basis for follow-up guidelines.