Associations between ocular melanoma and other primary cancers: an international population-based study.
Ocular melanoma is a rare neoplasm with a poorly understood etiology, especially concerning its link with ultraviolet-light exposure. Studying the risk of second primary cancers may help to formulate causal hypotheses. We used data from 13 cancer registries, including 10,396 first occurring ocular melanoma cases, and 404 second occurring cases. To compare the second cancer incidence in ocular melanoma patients to that in noncancer population, we calculated standardized incidence ratios (SIRs) of 32 types of cancer. We also calculated SIRs of second ocular melanoma after other primaries. Ocular melanoma patients had significantly increased risk of cutaneous melanoma (SIR = 2.38, 95% CI 1.77-3.14), multiple myeloma (SIR = 2.00, 1.29-2.95), and of liver (SIR = 3.89, 2.66-5.49), kidney (SIR = 1.70, 1.22-2.31), pancreas (SIR = 1.58, 1.16-2.11), prostate (SIR = 1.31, 1.11-1.54), and stomach (SIR = 1.33, 1.03-1.68) cancers. Risks of cutaneous melanoma were highly variable between registries and were mainly increased in females, in younger patients, in first years following diagnosis, and for patients diagnosed after 1980. The risk of ocular melanoma was significantly increased only after prostate cancer (SIR = 1.41, 1.08-1.82). Risk of cutaneous melanoma after ocular melanoma had epidemiological patterns, similar to cutaneous melanoma screening in the general population. The increased risk of cutaneous melanoma would be largely due to greater skin cancer surveillance in ocular melanoma patients, and not to common etiological factors. The high SIR found for liver cancer may be explained by misclassification bias. Common etiological factors may be involved in ocular and prostate cancers.
Scélo
Ghislaine
G
International Agency for Research on Cancer (IARC), Lyon, France.
Boffetta
Paolo
P
Autier
Philippe
P
Hemminki
Kari
K
Pukkala
Eero
E
Olsen
Jorgen H
JH
Weiderpass
Elisabete
E
Tracey
Elizabeth
E
Brewster
David H
DH
McBride
Mary L
ML
Kliewer
Erich V
EV
Tonita
Jon M
JM
Pompe-Kirn
Vera
V
Chia
Kee-Seng
KS
Jonasson
Jon G
JG
Martos
Carmen
C
Giblin
Michael
M
Brennan
Paul
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005134:Eye Neoplasms / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007390:International Agencies; D007680:Kidney Neoplasms / Q000453:epidemiology; D008113:Liver Neoplasms / Q000453:epidemiology; D008297:Male; D008545:Melanoma / Q000453:epidemiology*; D008875:Middle Aged; D009101:Multiple Myeloma / Q000453:epidemiology; D016609:Neoplasms, Second Primary / Q000453:epidemiology*; D011159:Population Surveillance; D011471:Prostatic Neoplasms / Q000453:epidemiology; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D012878:Skin Neoplasms / Q000453:epidemiology