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Family history of melanoma increases risk for skin cancer

Those with a family history of melanoma had a 74% increased risk for melanoma, according to a study that followed white participants for more than 20 years.

“Our results indicate that it is important to consider family history of melanoma in a first-degree relative when discussing risk of all skin cancers,” Erin X. Wei, MD, staff physician at Brigham and Women’s Hospital and instructor of dermatology at Harvard Medical School, and colleagues wrote.

The researchers followed 216,115 participants from the Nurses’ Health Study (NHS), Nurse’s Health Study 2 (NHS2) and Health Professionals Follow-up Study (HPFS) for more than 20 years.

Participants provided information via questionnaire on family history of melanoma and also reported new diagnoses of skin cancer biennially.

The 216,115 participants included 190,345 white women, of whom 84,467 were from the NHS and 105,878 from the NHS2. Also, 25,770 white men were included from HPFS.

Researchers analyzed 1,688 incidents of melanoma, 2,905 incident cases of squamous cell carcinoma (SCC) and 30,613 cases of basal cell carcinoma (BCC).

An association was identified between family history of melanoma and the risk for melanomas on the trunk and extremities, according to the study.

An increase in the risk for melanoma was identified at 94% on the trunk (HR = 1.94; 95% CI, 1.59-2.36) and by 83% on the extremities (HR = 1.83; 95% CI, 1.57-2.14).

A family history of melanoma and SCC was statistically significant for SCCs that develop on the extremities (HR = 1.22; 95% CI, 1.07-1.4), according to the researchers.

Those with a family history of melanoma had a 27% increase in the lifetime risk for BCC vs. those lacking a family history (HR = 1.27; 95% CI, 1.12-1.44).

The researchers noted the association between a family history of melanoma and the risk for developing melanoma mainly in melanomas on the trunk.

The association between a positive family history of melanoma and keratinocyte cancers was stronger in BCCs than in SCCs.

The self-reported nature of family history in the study represents one limitation, according to researchers.

A family history of melanoma increases a person’s risk for melanoma by threefold to eightfold, according to the study.

“Although our study confirmed that truncal melanomas show the strongest and most consistent association with a family history of melanoma across sexes, we also made the interesting observation that upper and lower extremity melanomas also show familial association in women,” Wei and colleagues wrote.

Historically, sun-exposed sites such as the head and/or neck are not known to be significantly associated with family history of melanoma, according to the researchers.

The researchers’ findings provide new evidence for clinical practice and risk stratification in patients with skin cancer, they added. – by Abigail Sutton

Disclosures: The authors report no relevant financial disclosures.