Melanomas More Easily Caught Through Known Risk Factors

A more personalized surveillance approach may help catch melanomas in high-risk patients.

Individuals with high-risk melanoma may reap the most benefit from a tailored surveillance program, according to a study published in JAMA Dermatology.

Since the incidence of melanoma is increasing in predominantly white populations, the researchers wanted find a way to improve the identification and treatment of higher-risk subgroups.

Researchers sought to characterize melanoma patients, and the clinical features associated with their melanomas according to patient risk factors, such as having numerous moles, a personal history of melanoma, and a family history.

For the study, researchers used the Melanoma Patterns of Care Study to classify 2727 melanoma patients as having high or lower risk, depending on whether they already had a personal or family history of melanoma, had many moles, or none of the 3 factors.

The results of the study showed that 39% of patients were defined as higher risk due to family history, multiple primary melanomas, or having numerous moles. The most common risk factor in this group was having many moles, followed by personal history and family history.

For higher-risk patients, the average age at diagnosis was 62-years-old, compared with patients at a lower risk who did not have these risk factors (65-years-old). However, the age did differ by risk, at 56-years-old for patients with a family history, 59-years-old for individuals with many moles, and 69-years-old for those with a previous melanoma.

The authors noted that patients with higher-risk who had many moles were more likely to have melanoma on the trunk of the body, while those with a family history were more likely to have it on the limbs. Furthermore, those with a personal history were more likely to have melanoma on the head and neck.

“The results of our study suggest that a person’s risk factor status might be used to tailor their surveillance program in terms of starting age and education about skin self-examination or more intensive surveillance,” said researcher Caroline G. Watts, MPH. “For instance, doctors could encourage people with many moles or with a family history of melanoma to start skin self-examination and monitoring at an earlier age than other people, and discuss the body sites that require particular attention.”

Although the findings showed promise, some limitations to the study included risk factors based on physician recall and patient medical records. Additionally, researchers did not assess the reliability or validity of the risk factor data.