Skin cancer may increase subsequent primary malignancy risk

By Helen Albert, Senior medwireNews Reporter

Research suggests that people with non-melanoma skin cancer (NMSC) are at moderately increased risk for developing other primary malignancies in the future, particularly breast and lung cancer and melanoma.

Previous studies have suggested that people who develop NMSC may have an altered risk for developing other cancers. "One view is that sunlight causes NMSC but also produces vitamin D, which in turn may reduce the risk of other cancers," explain study author Jiali Han (Harvard Medical School, Boston, Massachusetts, USA) and colleagues.

"Another view is that NMSC and other cancers may share common carcinogenic exposures or molecular mechanisms in their etiology, such as DNA repair deficiency and immune suppression, and thus the history of NMSC may indicate an increased risk of subsequent cancer development," they add.

Han and team followed up 46,237 men from the Health Professionals Follow-up Study (HPFS) between 1986 and 2008 and 107,339 women from the Nurses' Health Study (NHS) between 1984 and 2008 for history of NMSC and other primary cancers.

In total, 4561 men and 11,068 women from the two cohorts had NMSC. When the researchers evaluated their risk for developing other primary cancers, they found that men and women with NMSC had significant 11% and 20% increased risks for developing other primary cancers, respectively, a mean time of 9.67 years later.

This increased risk could largely be accounted for by a significant 1.99-fold increased relative risk for melanoma in men and a 1.19-, 1.32-, and 2.58-fold increased risk for breast cancer, lung cancer, and melanoma, respectively, in women.

Writing in PLoS Medicine, Han and co-authors warn: "Because our study was observational, these results should be interpreted cautiously and are insufficient evidence to alter current clinical recommendations."

They conclude: "Nevertheless, these data support a need for continued investigation of the potential mechanisms underlying this relationship."

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