Personal History of Prostate Cancer Increases Risk of Melanoma
History of severe acne, which is a surrogate for high androgen activity, has been associated with increased risk of prostate cancer and recent data suggest that severe teenage acne is a risk factor for melanoma. In a study reported in the Journal of Clinical Oncology, Wen-Qing Li, PhD, of the National Cancer Institute, and colleagues investigated the potential association between prostate cancer and melanoma. Their findings suggest that personal history of prostate cancer is associated with significantly increased risk of melanoma.
Study Details
The study was a prospective evaluation of the association of prostate cancer and incident melanoma among 42,372 men in the Health Professionals’ Follow-Up Study (HPFS, 1986–2012). Prostate cancer, melanoma, and nonmelanoma skin cancer diagnoses were self-reported biennially and prostate cancer and melanoma diagnoses were pathologically confirmed. The association between prostate cancer diagnosis and melanoma was also examined among 18,603 men in the Physicians’ Health Study (1982–1998).
Increased Risk of Melanoma
During 747,176 person-years of follow-up, 5,091 prostate cancers and 539 melanomas were identified in the HPFS. Men with prostate cancer were older and reported greater ever-use of sildenafil citrate for erectile dysfunction. Personal history of prostate cancer was significantly associated with increased risk of melanoma (adjusted hazard ratio [HR] = 1.83, 95% confidence interval [CI] = 1.32–2.54) on multivariate analysis adjusting for age, body mass index, smoking status, alcohol intake, physical activity, ever-use of sildenafil citrate for erectile dysfunction, childhood reaction to sun, number of sunburns, mole count, hair color, family history of melanoma, sun exposures by age, and ultraviolet (UV) index by age.
Adjustment for midrange UV radiation exposure (UVB flux) and adjustment for severe acne did not alter the association. Mole counts were not significantly related to risk of prostate cancer, although there was a borderline significant interaction (P=.08 for interaction) between prostate cancer and melanoma risk according to presence of moles.
During 692,290 person-years of follow-up, 11,960 nonmelanoma skin cancers (squamous cell or basal cell carcinoma) were identified in the HPFS. Patients with prostate cancer had a slight and nonsignificant increase in risk for nonmelanoma skin cancers (adjusted HR = 1.08, 95% CI = 0.995–1.16).
No Increased Risk of Other Cancers
Personal history of prostate cancer was not significantly associated with risk of other cancers (eg, HR = 1.23, 95% CI = 0.96–1.57, for lung cancer, and HR = 1.16, 95% CI = 0.82–1.63, for colorectal cancer). Risk for melanoma was not significantly associated with history of cancers other than prostate cancer, with few patients with other major cancers developing melanoma during follow-up (eg, three patients with colorectal cancer and none with lung cancer). In addition, personal history of melanoma was not associated with increased risk of prostate cancer (HR = 0.88, 95% CI = 0.57–1.35).
The association between prostate cancer diagnosis and increased risk for melanoma was confirmed in the Physicians’ Health Study cohort, in which 166 melanomas were identified in 251,850 person-years of follow-up. In a multivariate analysis adjusting for age, body mass index, smoking status, alcohol intake, and physical activity, the hazard ratio for melanoma in patients with history of prostate cancer was 2.17 (95% CI = 1.12–4.21). For both cohorts combined, the hazard ratio was 1.89 (95% CI = 1.41–2.54).
The investigators concluded, “Personal history of prostate cancer is associated with an increased risk of melanoma, which may not be entirely a result of greater medical scrutiny.”
The study was supported by the National Cancer Institute.
Jiali Han, PhD, of Brigham and Women’s Hospital and Harvard Medical School, is the corresponding author for the Journal of Clinical Oncology article.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
