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  • Distribution of Subsequent Primary Invasive Melanomas Following a First Primary Invasive or In Situ Melanoma in Queensland, Australia, 1982-2010

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    Author(s)
    Youlden, Danny R
    Youl, Philippa H
    Soyer, H Peter
    Aitken, Joanne F
    Baade, Peter D
    Griffith University Author(s)
    Baade, Peter D.
    Youlden, Danny R.
    Aitken, Joanne
    Year published
    2014
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    Abstract
    Importance Melanoma survivors are known to have a highly elevated risk of subsequent primary melanomas. Objective To determine the relative risk of subsequent primary invasive melanomas following a first primary invasive or in situ melanoma, with a focus on body site. Design, Setting, and Participants A retrospective cohort study was conducted using population-based administrative data for melanoma diagnoses collected by the Queensland Cancer Registry, Queensland, Australia. Deidentified records of all cases of melanoma among Queensland residents during the period 1982-2005 were obtained and reviewed to December 31, ...
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    Importance Melanoma survivors are known to have a highly elevated risk of subsequent primary melanomas. Objective To determine the relative risk of subsequent primary invasive melanomas following a first primary invasive or in situ melanoma, with a focus on body site. Design, Setting, and Participants A retrospective cohort study was conducted using population-based administrative data for melanoma diagnoses collected by the Queensland Cancer Registry, Queensland, Australia. Deidentified records of all cases of melanoma among Queensland residents during the period 1982-2005 were obtained and reviewed to December 31, 2010. There were 39?668 eligible cases of first primary invasive melanoma and 22?845 cases of first primary in situ melanoma. Main Outcomes and Measures Standardized incidence ratios (SIRs), a proxy measure for relative risk, were calculated by dividing the observed number of subsequent primary invasive melanomas by the product of the strata-specific incidence rates that occurred in the general population and the cumulative time at risk for the cohort. Synchronous subsequent melanomas (diagnosed within 60 days of the first primary melanoma) were excluded. Differences between SIRs were assessed using multivariate negative binomial regression adjusted for sex, age group, time to second diagnosis, and body site and expressed in terms of adjusted SIR ratios with corresponding 95% CIs. Results There were 5358 subsequent primary invasive melanomas diagnosed, resulting in SIRs of 5.42 (95% CI, 5.23-5.61) and 4.59 (4.37-4.82) for persons with a first primary invasive or in situ melanoma, respectively. The SIRs remained elevated throughout the follow-up period. In general, subsequent primary invasive melanomas were more likely to occur at the same body site as the initial invasive or in situ melanoma. The largest relative risk was for females with a first primary invasive melanoma on the head followed by a subsequent primary invasive melanoma also on the head (SIR, 13.32; 95% CI, 10.28-16.98). Conclusions and Relevance Melanoma survivors require ongoing surveillance, with particular attention required for the body site of the initial lesion. Clinical practice guidelines have recognized the importance of monitoring for people with invasive melanoma; the results of the present study highlight the need for similar levels of supervision for those with a diagnosis of in situ melanoma.
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    Journal Title
    JAMA Dermatology
    Volume
    150
    Issue
    5
    DOI
    https://doi.org/10.1001/jamadermatol.2013.9852
    Copyright Statement
    © 2014 American Medical Association (AMA). This is the author-manuscript version of this paper. Reproduced in accordance with the copyright policy of the publisher. Please refer to the journal's website for access to the definitive, published ve
    Subject
    Clinical sciences
    Oncology and carcinogenesis
    Oncology and carcinogenesis not elsewhere classified
    Publication URI
    http://hdl.handle.net/10072/63978
    Collection
    • Journal articles

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