title: Risk of subsequent cutaneous malignancy in patients with prior melanoma: a systematic review and meta-analysis.
abstract: Melanoma patients are known to be at risk of developing multiple cutaneous (pre-) malignancies, however, the exact dimensions of these risks are unknown. In this meta-analysis, risks of developing a melanoma, basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) after a melanoma were investigated. An extensive systematic literature search was conducted (last performed on 18 January 2012). Studies reporting risks, i.e. proportions, standardized incidence ratios (SIR) and cumulative risks (CRs) were included. Fifty, of 233 fully read articles, met selection criteria. Two independent reviewers extracted data on study characteristics and risks measurements. Random-effects meta-analyses were used to pool the risk estimates for the three tumour combinations. In melanoma patients, pooled proportions for a subsequent melanoma, BCC or SCC were respectively 3.8% (n = 47), 2.8% (n = 5) and 1.0% (n = 6). The pooled SIRs for a subsequent melanoma, BCC or SCC in melanoma patients were respectively 10.4 (n = 12), 4.6 (n = 2) and 2.8 (n = 2). Mean 20-year CRs of a subsequent melanoma, BCC or SCC in melanoma patients were respectively 5.4% (n = 3), 14.0% (n = 1) and 4.0% (n = 1). Subgroup analyses showed substantial differences in reported risks between continents and study design. In conclusion, a history of a prior melanoma is a strong predictor for development of a subsequent melanoma (approximately 10-fold increased risk) and to a lesser extent BCC or SCC. This information could serve as information for health care systems. Further, secondary prevention seems pivotal in this patient group.
authors.affiliation: Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
authors.forename: R J T
authors.initials: RJ
authors.lastname: van der Leest
authors.affiliation: Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
authors.forename: S C
authors.initials: SC
authors.lastname: Flohil
authors.affiliation: Department of Biostatistics, Erasmus MC University Medical Center, Rotterdam, The Netherlands.|Pedagogical and Educational Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands.|Institute of Psychology, Erasmus University Rotterdam, Rotterdam, The Netherlands.
authors.forename: L R
authors.initials: LR
authors.lastname: Arends
authors.affiliation: Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.|Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: de Vries
authors.affiliation: Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: Nijsten
mesh_terms: D002280:Basal Cell Carcinoma / Q000453:epidemiology*; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008545:Melanoma / Q000453:epidemiology*; D016609:Neoplasms, Second Primary / Q000453:epidemiology*; D018570:Risk Assessment; D012737:Sex Factors; D012878:Skin Neoplasms / Q000453:epidemiology*