Identifying high-risk melanoma patients: The importance of acquiring a detailed family history

IF 8 2区医学 Q1 DERMATOLOGY Journal of the European Academy of Dermatology and Venereology Pub Date : 2025-03-04 DOI:10.1111/jdv.20601

M. R. Jansen, M. El Moumni, B. L. van Leeuwen, P. C. van den Akker, E. Rácz

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Abstract

Background

It is essential to identify individuals with the highest risk of developing melanoma and to withhold individuals from surveillance with a low risk. However, international consensus on surveillance indications and the role of family history is still lacking.

Objectives

To provide more insight into the association between a family history of melanoma and the risk of developing melanoma.

Methods

Adults who participated in the surveillance programme of the University Medical Center Groningen between June 1995 and November 2017 were retrospectively included. Participants were stratified into risk groups according to genetic assessment and family history following current Dutch guidelines: hereditary melanoma (risk group 1), familial melanoma (risk group 2) and their first-degree relatives (risk group 3), and other screening reasons (risk group 0). We included individuals fulfilling the ‘possible familial melanoma’ criteria (risk group 4) and their first-degree relatives (risk group 5), as evolving Dutch guidelines no longer recommend to screen these individuals. Melanoma incidence during follow-up was compared with the general population using standardized incidence ratios (SIRs), and the rate of developing melanomas was compared between risk groups and expressed as adjusted hazard ratios (aHRs).

Results

In total, 224 participants were included (mean age 44.7 years; 56.7% female). During a median follow-up of 5.6 years (IQR, 3.7–7.8), a total number of 61 melanomas were diagnosed among 38 (17.0%) participants. The overall melanoma risk was significantly higher than in the general population (SIR 73). The rate of developing melanoma in risk group 4 was comparable to risk group 2 (aHR 1.27, p = 0.576).

Conclusions

Stratification of individuals according to their family history of melanoma identifies those with a high risk of developing melanoma. Contrary to Dutch recommendations, surveillance should also be considered for melanoma patients fulfilling the ‘possible familial melanoma’ criteria.

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识别高危黑色素瘤患者：获得详细家族史的重要性。

背景：确定患黑色素瘤风险最高的个体，并将低风险个体排除在监测之外是至关重要的。然而，国际上对监测指征和家族史的作用仍然缺乏共识。目的：为黑色素瘤家族史与患黑色素瘤风险之间的关系提供更多的见解。方法：回顾性纳入1995年6月至2017年11月期间参加格罗宁根大学医学中心监测项目的成年人。根据基因评估和家族史，参与者按照目前荷兰的指导方针分为风险组：遗传性黑色素瘤（风险组1），家族性黑色素瘤（风险组2）及其一级亲属（风险组3），以及其他筛查原因（风险组0）。我们纳入了符合“可能的家族性黑色素瘤”标准的个体（风险组4）及其一级亲属（风险组5），因为不断发展的荷兰指南不再建议对这些个体进行筛查。使用标准化发病率比（SIRs）将随访期间黑色素瘤的发病率与普通人群进行比较，并将不同风险组间黑色素瘤的发生率进行比较，并以调整风险比（aHRs）表示。结果：共纳入224名参与者(平均年龄44.7岁；56.7%的女性)。在中位随访5.6年（IQR, 3.7-7.8）期间，38名（17.0%）参与者共诊断出61个黑色素瘤。总体黑色素瘤风险明显高于普通人群（SIR 73）。风险组4的黑色素瘤发病率与风险组2相当（aHR为1.27,p = 0.576）。结论：根据黑色素瘤家族史对个体进行分层，可以识别出患黑色素瘤的高风险人群。与荷兰的建议相反，还应考虑对符合“可能的家族性黑色素瘤”标准的黑色素瘤患者进行监测。

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来源期刊

Journal of the European Academy of Dermatology and Venereology 医学-皮肤病学

CiteScore

10.70

自引率

8.70%

发文量

874

审稿时长

3-6 weeks

期刊介绍： The Journal of the European Academy of Dermatology and Venereology (JEADV) is a publication that focuses on dermatology and venereology. It covers various topics within these fields, including both clinical and basic science subjects. The journal publishes articles in different formats, such as editorials, review articles, practice articles, original papers, short reports, letters to the editor, features, and announcements from the European Academy of Dermatology and Venereology (EADV). The journal covers a wide range of keywords, including allergy, cancer, clinical medicine, cytokines, dermatology, drug reactions, hair disease, laser therapy, nail disease, oncology, skin cancer, skin disease, therapeutics, tumors, virus infections, and venereology. The JEADV is indexed and abstracted by various databases and resources, including Abstracts on Hygiene & Communicable Diseases, Academic Search, AgBiotech News & Information, Botanical Pesticides, CAB Abstracts®, Embase, Global Health, InfoTrac, Ingenta Select, MEDLINE/PubMed, Science Citation Index Expanded, and others.