Merkel cell carcinoma linked to higher risk for subsequent cancers
Click Here to Manage Email Alerts
Key takeaways:
- Patients with Merkel cell carcinoma had increased risk for subsequent solid tumors and hematologic malignancies.
- Lymphoma incidence more than doubled among those diagnosed with Merkel cell carcinoma.
Patients with Merkel cell carcinoma have an increased risk for developing subsequent primary solid tumors and hematologic malignancies, according to data published in JAMA Dermatology.
“This could be due to enhanced surveillance after diagnosis of [Merkel cell carcinoma] that resulted in increased detection rates, possible lead time bias, or a true biological association between [Merkel cell carcinoma] and these subsequent primary cancers,” Edward Eid, MD, a postdoctoral research fellow in the department of dermatology at Stanford University, and researchers, wrote.
“We identified previously unreported increased risks [for] developing liver, pancreatic, thyroid and kidney cancers after a [Merkel cell carcinoma] diagnosis.”
Background and methodology
Researchers sought to investigate potential risk among patients with Merkel cell carcinoma (MCC) for developing subsequent primary cancers following diagnosis of a first primary cutaneous MCC.
Eid and colleagues conducted a cohort study consisting of data from 2000 to 2019 from 17 SEER-based patient registries. The analysis included 6,146 patients (60.4% male; 89.3% white) diagnosed with a first primary MCC.
Relative and absolute risks for subsequent primary cancers following diagnosis of a first primary MCC served as the study’s primary outcome measurement. Researchers calculated values using the standardized incidence ratio (SIR) — determined as the ratio of observed to expected cases of subsequent cancer — and excess risk, which they determined by the difference between observed and expected cases of subsequent cancer divided by person-years at risk.
Results, next steps
Of the 6,146 patients analyzed, 725 (11.8%) developed subsequent primary cancers, for an SIR of 1.28 (95% CI, 1.19-1.38) and excess risk of 57.25 per 10,000 person-years.
Notably, patients with solid tumors after MCC diagnosis had an elevated risk for liver cancer (SIR = 1.92; 95% CI, 1.09-3.11; excess risk, 2.77 per 10,000 person-years), kidney cancer (SIR = 1.64; 95% CI, 1.08-2.39; excess risk, 3.83 per 10,000 person-years), pancreatic cancer (SIR = 1.65; 95%CI, 1.13-2.32; excess risk, 4.55 per 10,000 person-years), cutaneous melanoma (SIR = 2.36; 95% CI, 1.85-2.97; excess risk, 15.27 per 10,000 person-years) and papillary thyroid carcinoma (SIR = 5.26; 95% CI, 3.25-8.04; excess risk, 6.16 per 10,000 person-years).
Patients with hematologic malignancies after MCC diagnosis had an increased risk for non-Hodgkin lymphoma (SIR = 2.62; 95% CI, 2.04-3.32; excess risk, 15.48 per 10,000 person-years) and myelodysplastic syndromes (SIR = 2.17; 95% CI, 1.18-3.64, excess risk, 2.73 per 10,000 person-years).
Researchers acknowledged potential study limitations, including possible surveillance bias, because many patients with MCC undergo regular screening with CT or PET, which could identify other cancers.
“This study strengthens previously reported associations with MCC and the subsequent development of other cancers, and it sheds light on potentially novel associations that could contribute to a better understanding of the etiology of this aggressive tumor,” Eid and colleagues wrote.
Collapse
Eid E, et al. JAMA Dermatol. 2023;doi:10.1001./jamadermatol.2023.2849.
Click Here to Manage Email Alerts