Real-world evaluation of the use of melanoma risk prediction tools by clinicians in Australia: a mixed methods study
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Effectiveness of a stepped-care model to address fear of cancer recurrence in patients with early-stage melanoma: results at 6- and 12-month follow-up
Abstract Purpose: To investigate the effectiveness of the Melanoma Care Program, an evidence-based, psychological intervention delivered through a stepped-care model, to address fear of cancer recurrence (FCR) in patients with early-stage melanoma at 6- and 12-month follow-up, when implemented into routine practice. Methods: Individuals with stage 0-II melanoma participated in FCR severity screening using the Fear of Cancer Recurrence Inventory. Participants with an FCR severity score of ≤ 12 were offered usual care. Participants with an FCR severity score of ≥ 13 were offered a psychoeducational booklet and a stepped-care model offering participants up to 5 psychotherapeutic telehealth sessions with a [...]
Tumor miRNA Signatures Associate with Outcomes of Patients with Stage II/III Melanoma
Abstract Purpose: Patients with stage II and resected stage III melanomas have variable clinical outcomes, providing evidence of underlying biological differences in tumors and/or the patients themselves, beyond stage. The approval of adjuvant immunotherapy for stage IIB/C and resected stage III/IV disease (and adjuvant targeted therapy for resected stage III disease) has created a pressing need to develop biomarkers to accurately distinguish patients at low risk versus high risk for recurrence and death from melanoma. miRNAs are promising biomarkers because of their stability in tissues and fluids and their demonstrated functional and prognostic roles in melanoma. We hypothesized that miRNA [...]
DNA Methylation Classes of Stage II and III Primary Melanomas and Their Clinical and Prognostic Significance
Abstract Purpose: Patients with stage II and III cutaneous primary melanoma vary considerably in their risk of melanoma-related death. We explore the ability of methylation profiling to distinguish primary melanoma methylation classes and their associations with clinicopathologic characteristics and survival. Materials and methods: InterMEL is a retrospective case-control study that assembled primary cutaneous melanomas from American Joint Committee on Cancer (AJCC) 8th edition stage II and III patients diagnosed between 1998 and 2015 in the United States and Australia. Cases are patients who died of melanoma within 5 years from original diagnosis. Controls survived longer than 5 years without evidence of [...]
Absolute Risk of Developing a Second Primary Cancer After a First Primary Melanoma: An Australian Population-Based Cohort Study.
Abstract Understanding the absolute risk of developing a second primary cancer is important to guide patient surveillance and education. We aimed to examine the cumulative incidence and factors associated with development of a second primary cancer (melanoma versus other) after diagnosis of a first primary melanoma (invasive or in situ). We analysed a population-based study cohort of 154,695 people diagnosed with a first primary melanoma in New South Wales, Australia, between 1982-2019. The cohort was followed for future cancer incidence and vital status for a median of 7.0 years. We used Fine-Gray models to account for death as a [...]
Global Burden of Cutaneous Melanoma in 2020 and Projections to 2040
Abstract Importance: Despite many cases being preventable, cutaneous melanoma remains the most serious skin cancer worldwide. Understanding the scale and profile of the disease is vital to concentrate and reinforce global prevention efforts. Objective: To examine global patterns of cutaneous melanoma in 2020 and to provide projected estimates of cases and deaths by 2040. Design, setting, and participants: This population-based study used the GLOBOCAN 2020 database for global epidemiological assessment of new cases and deaths due to invasive melanoma. Main outcomes and measures: Age-standardized incidence and mortality rates were calculated per 100 000 person-years by country, world region, and 4-tier level of human [...]
Association of inherited genetic variants with multiple primary melanoma.
Abstract Background: Recent genome-wide association studies (GWAS) have identified new susceptibility loci for melanoma, but their associations with multiple primary melanoma (MPM) are unclear. Methods: We investigated the associations of 69 single nucleotide polymorphisms (SNPs) in 39 GWAS-identified loci with odds of MPM relative to single primary melanoma (SPM) in the international, population-based Genes, Environment, and Melanoma (GEM) study. Per-minor allele odds ratios (ORs) and 95% confidence intervals (CIs) for individuals with MPM 'cases' (n=1,205) relative to SPM 'controls' (n=2,458) were estimated using multivariable logistic regression, and polygenic risk scores (PRS) were calculated and weighted based on a 2020 GWAS meta-analysis [...]
In vivo reflectance confocal microscopy role for early to advanced lentigo maligna melanoma spectrum: A systematic review and pooled analysis.
Abstract Background: Lentigo maligna (LM) is a growing problem worldwide and the main type of melanoma in situ in some Caucasian populations. It presents as a spectrum from atypical intraepidermal melanocytic proliferation (AIMP) to invasive lentigo maligna melanoma (LMM). Accurate diagnosis and staging are crucial for determining appropriate management strategies. Objectives: To assess the role of in vivo reflectance confocal microscopy (RCM) in differentiating early and advanced stages of lentigo maligna. Methods: A systematic search was conducted on Medline, PubMed, Scopus, Web of Science, Proquest Central, Embase, Cochrane and Google Scholar. References of included and excluded studies were reviewed for additional sources. [...]
Sociodemographic and health factors associated with genetic testing in Australia: insights from a cohort-based study of 45,061 participants.
Abstract With increasing availability of genetic tests, it is important to consider differences in testing patterns between population subgroups. We examined self-reported genetic testing among 45,061 participants of the Australian population-based 45 and Up Study, testing for associations with sociodemographic and health characteristics (multivariable logistic regression). 9.2% of participants reported ever having genetic testing; 3.9% reported disease-related testing, 5.2% non-disease-related testing, 0.7% both disease-related and non-disease-related testing. Disease-related genetic testing was strongly associated with younger age, female sex, history of cancers and cardiovascular disease, and cancer family history. Disease-related testing was also strongly associated with higher education (university versus [...]
Sex differences in melanoma survival-a GEM study.
Abstract Sex differences in melanoma are prominent, with female having a significant survival advantage. However, it is unclear why we see this survival advantage. Here, we investigate the relationship between sex, clinicopathologic variables, and melanoma specific survival in 1753 single primary melanomas from patients in the GEM (Genes, Environment, and Melanoma) study. Using Cox proportional hazard models and formal mediation analysis, the effect of sex on survival is explained largely by differences in the clinicopathologic features of tumors at diagnosis. Specifically, we find evidence that 86.5% of the effect of sex on melanoma survival is mediated by differences in [...]