Second Strike: Understanding Melanoma's Return and Optimal Surveillance

Original Article: Incidence and Factors Associated With Second Primary Invasive Melanoma in Norway

What are the key takeaways of this article?

In one of JAMA’s most frequently read articles of the past week, Ghiasvand et al. report on the incidence and risk factors for second primary invasive melanoma in the Norwegian population. This research utilized the Cancer Registry of Norway, including records from 19,196 adults diagnosed with a first primary melanoma between 2008 and 2020, thereby offering a comprehensive look at the patterns and risks associated with secondary melanoma occurrences.

The study's findings reveal a notably high incidence rate of second primary melanoma within the first year following the initial diagnosis, recorded at 16.8 per 1000 person-years. This rate decreases significantly to 7.3 per 1000 person-years in the second year and then levels off, indicating a pronounced vulnerability period immediately after the first melanoma diagnosis. Critical risk factors identified for the occurrence of a second primary melanoma include older age (specifically those aged 50 years and above) and male sex. Both were associated with an increased risk and a shorter interval before the occurrence of a second primary melanoma. These findings have crucial implications for clinical practice, suggesting an imperative need for intensified surveillance, especially in the first three years post-diagnosis, focusing on older male patients.

Despite the strengths of the work conducted by Ghiasvand et al. their research is subject to some limitations, namely the absence of data on phenotypic characteristics, personal UV radiation exposure, genetic factors, and the frequency of follow-up skin examinations. This work offers crucial insights into the dynamics of second primary invasive melanoma development and highlights the need for targeted surveillance strategies. By identifying key risk factors such as age and gender, their research paves the way for more personalized and effective management of melanoma patients, potentially improving patient outcomes and quality of life for those at risk.

Publication Date: April 7th, 2024

Reference: Ghiasvand R, Green AC, Veierød MB, Robsahm TE. Incidence and Factors Associated With Second Primary Invasive Melanoma in Norway. JAMA Dermatol. Published online February 28, 2024. doi:10.1001/jamadermatol.2023.6251

Summary By: Parsa Abdi