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Nonmelanoma skin cancer increased subsequent primary cancer risk
Nonmelanoma skin cancer was associated with an increased risk for subsequent primary cancers, especially among younger patients, and secondary primary salivary gland, melanoma, bone and upper gastrointestinal tract malignancies, according to study data.
“Our study shows that nonmelanoma skin cancer susceptibility is an important indicator of susceptibility to malignant tumors and that the risk is especially high among people who develop nonmelanoma skin cancer at a young age,” Rodney Sinclair, MBBS, MD, director of dermatology at the Epworth Hospital and professor of medicine at the University of Melbourne in Australia, said in a press release. “The risk increases for a large group of seemingly unrelated cancers; however, the greatest risk relates to other cancers induced by sunlight, such as melanoma.”
Rodney Sinclair
Sinclair and colleagues evaluated data from an all England record-linked hospital and mortality 1999 to 2011 database. They identified 502,490 patients with a history of nonmelanoma skin cancer and more than 8 million adults without nonmelanoma skin cancer who served as controls.
Overall, patients with nonmelanoma skin cancer were 1.36 times (95% CI, 1.35-1.37) more likely to develop subsequent primary cancers. This risk remained significant when researchers excluded subsequent skin cancers from the analysis (RR=1.27; 95% CI, 1.26-1.28).
Patients with nonmelanoma skin cancer were at significant risk for developing 26 of the 29 secondary cancers evaluated compared with the control cohort (all P˂.05). The risk for subsequent primary cancer was highest for developing salivary gland (RR=5.78; 95% CI, 5.29-6.32), melanoma (RR=5.54; 95% CI, 5.37-5.71), bone (RR=2.93; 95% CI, 2.66-3.23) and upper gastrointestinal tract (RR=2.36; 95% CI, 2.25-2.48) cancers.
Researchers then stratified risk by age. Patients younger than 25 years had the highest risk for subsequent primary cancers (RR=22.6; 95% CI, 18-28.2), followed by those aged 25 to 44 years (RR=3.52; 95% CI, 3.3-3.75), 45 to 49 years (RR=1.74; 95% CI, 1.7-1.79) and at least 60 years (RR=1.32; 95% CI, 1.3-1.33).
“Early detection of cancers through screening of asymptomatic people works best when screening can be targeted at those at greatest risk,” Sinclair said. “Our study identifies people who receive a diagnosis of nonmelanoma skin cancer at a young age as being at increased risk for cancer and, therefore, as a group who could benefit from screening for internal malignancy.”
Disclosure: The researchers report no relevant financial disclosures.
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