Clinical Features Associated With Individuals at Higher Risk of Melanoma: A Population-Based Study.
The identification of a subgroup at higher risk of melanoma may assist in early diagnosis.



To characterize melanoma patients and the clinical features associated with their melanomas according to patient risk factors: many nevi, history of previous melanoma, and family history of melanoma, to assist with improving the identification and treatment of a higher-risk subgroup.



The Melanoma Patterns of Care study was a population-based observational study of physicians' reported treatment of 2727 patients diagnosed with an in situ or invasive primary melanoma over a 12-month period from October 2006 to 2007 conducted in New South Wales. Our analysis of these data took place from 2015 to 2016.



Age at diagnosis and body site of melanoma.



Of the 2727 patients with melanoma included, 1052 (39%) were defined as higher risk owing to a family history of melanoma, multiple primary melanomas, or many nevi. Compared with patients with melanoma who were at lower risk (ie, without any of these risk factors), the higher-risk group had a younger mean age at diagnosis (62 vs 65 years, P < .001), but this differed by risk factor (56 years for patients with a family history, 59 years for those with many nevi, and 69 years for those with a previous melanoma). These age differences were consistent across all body sites. Among higher-risk patients, those with many nevi were more likely to have melanoma on the trunk (41% vs 29%, P < .001), those with a family history of melanoma were more likely to have melanomas on the limbs (57% vs 42%, P < .001), and those with a personal history were more likely to have melanoma on the head and neck (21% vs 15%, P = .003).



These findings suggest that a person's risk factor status could be used to tailor surveillance programs and education about skin self-examination.
Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.
Caroline G
CG
Watts
Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.
Christine
C
Madronio
NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW Australia.
Rachael L
RL
Morton
Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Chris
C
Goumas
Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.
Bruce K
BK
Armstrong
School of Public Health, Rural Health Northern Rivers, Lismore, NSW, Australia.
Austin
A
Curtin
Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, and the Discipline of Dermatology, The University of Sydney, Sydney, NSW, Australia.
Scott W
SW
Menzies
Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia6Centre for Cancer Research, Westmead Institute for Medical Research, The University of Sydney, Westmead, NSW, Australia.
Graham J
GJ
Mann
Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
John F
JF
Thompson
Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia3Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Anne E
AE
Cust
D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D005121:Extremities; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology; D009508:Nevus, Pigmented / Q000453:epidemiology* / Q000473:pathology; D009517:New South Wales / Q000453:epidemiology; D012307:Risk Factors; D012878:Skin Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology; D060726:Torso; D047368:Tumor Burden