Precision Medicine in Action: Clinical Features May Help ID High Risk Melanoma Patients

Zeroing in on an individual’s risk factors for melanoma can help identify high-risk patients who may benefit from increased surveillance, new research suggests.

Caroline G. Watts, M.P.H., of the University of Sydney, Australia, and coauthors examined clinical features associated with melanomas according to patient risk factors (many moles, history of previous melanoma and family history of melanoma) to improve the identification and treatment of those at higher risk. The findings appear in JAMA Dermatology.

The study included 2,727 patients with melanoma, of whom 1,052 (39 percent) were defined as higher risk because of family history, multiple primary melanomas or many moles. The most common risk factor in this group was having many moles, followed by a personal history and a family history.

The average age at diagnosis was younger for higher-risk patients (62 vs. 65 years) compared with those patients at lower risk because they did not have these risk factors. However,  age differed by risk factor: 56 years for patients with a family history, 59 years for those with many moles and 69 years for those with a previous melanoma, the study showed.

Also, higher-risk patients with many moles were more likely to have melanoma on the trunk, those with a family history were more likely to have melanomas on the limbs, and those with a personal history were more likely to have melanoma on the head and neck, the researchers report.

“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,” the study authors conclude.

Limitations of the study include risk factors based on physician recall and patient medical records. The authors also did not assess the reliability or validity of the risk factor data.