title: The risk of developing a second primary cancer in melanoma patients: a comprehensive review of the literature and meta-analysis.
abstract: The number of cutaneous melanoma survivors has been increasing for years due to improvements in early diagnosis and subsequent prolonged survival. These patients are at increased risk of developing a second melanoma and a second primary malignancy (SPM) at other sites as well. We performed a review of scientific literature and meta-analysis to evaluate the risk of developing a SPM (other than melanoma) among melanoma patients. Twenty-three independent papers and over 350,000 melanoma patients were included. Risk of cancer among melanoma survivors was increased overall (1.57, 95% CI 1.29-1.90) and at several sites: bone (2.09, 95% CI 1.08-4.05), non-melanoma skin cancer (4.01, 95% CI 1.81-8.87), soft tissue (6.80, 95% CI 1.29-35.98), colon-rectum (1.12, 95% CI 1.00-1.25), female breast (1.14, 95% CI 1.07-1.22), kidney (1.34, 95% CI 1.23-1.45), prostate (1.25, 95% CI 1.13-1.37) and non-Hodgkin lymphoma (1.37, 95% CI 1.22-1.54). The overall risk of SPM showed a tendency to decrease as the time from melanoma diagnosis lengthened. Most of our findings may be explained by the tendency of some exposures, which are risk factors for different tumors, to occur simultaneously in the same individuals. These results suggest primary and secondary cancer prevention counselling for melanoma survivors.
authors.affiliation: Unit of Molecular and Nutritional Epidemiology, Institute for Cancer Research and Prevention, Via delle Oblate 2, 50139 Florence, Italy. Electronic address: s.caini@ispo.toscana.it.
authors.forename: Saverio
authors.initials: S
authors.lastname: Caini
authors.affiliation: International Prevention Research Institute, Lyon, France.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Boniol
authors.affiliation: Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Botteri
authors.affiliation: Division of Melanoma and Muscolocutaneous sarcoma, European Institute of Oncology, Milan, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Tosti
authors.affiliation: Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Bazolli
authors.affiliation: Library, European Institute of Oncology, Milan, Italy.
authors.forename: William
authors.initials: W
authors.lastname: Russell-Edu
authors.affiliation: European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium.
authors.forename: Francesco
authors.initials: F
authors.lastname: Giusti
authors.affiliation: Division of Melanoma and Muscolocutaneous sarcoma, European Institute of Oncology, Milan, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Testori
authors.affiliation: Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Gandini
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D018570:Risk Assessment; D012307:Risk Factors; D012878:Skin Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D017741:Survivors / Q000706:statistics & numerical data*; D013997:Time Factors
keywords: Melanoma; Meta-analysis; Second primary cancers; Systematic review