Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indianapolis, Indiana.
J Am Acad Dermatol. 2019 Aug;81(2):489-499. doi: 10.1016/j.jaad.2019.04.044. Epub 2019 Jun 21.
Previous studies have found familial aggregation of melanoma and keratinocyte cancers (KCs).
We sought to determine the risk of melanoma and KCs in those with a positive family history of melanoma while controlling for pigmentary and environmental risk factors.
We prospectively followed 216,115 participants from the Nurses' Health Study, Nurse's Health Study 2, and Health Professionals Follow-up Study for more than 20 years. Cox proportional hazards regression controlling for known risk factors for skin cancer was used to estimate association between family history of melanoma and melanoma and KCs.
Compared with those without a family history of melanoma, individuals with a family history of melanoma had a 74% increased risk of melanoma (hazard ratio [HR], 1.74; 95% confidence interval [CI], 1.45-2.09), a 22% increased risk of squamous cell carcinoma (HR, 1.22; 95% CI, 1.06-1.40), and a 27% increased risk of basal cell carcinoma (HR, 1.27; 95% CI, 1.12-1.44). Family history of melanoma increased the risk of development of truncal melanoma in both sexes, extremity melanoma in women, and extremity squamous cell carcinoma in women.
Limitations of this study include self-reported family history and detection bias.
Individuals with a family history of melanoma are at an increased risk of melanoma and KCs.
先前的研究发现黑色素瘤和角质形成细胞癌(KCs)存在家族聚集现象。
我们旨在确定在控制色素和环境风险因素的情况下,有黑色素瘤家族史的个体患黑色素瘤和 KCs 的风险。
我们前瞻性地随访了来自护士健康研究、护士健康研究 2 和健康专业人员随访研究的 216115 名参与者超过 20 年。使用 Cox 比例风险回归控制皮肤癌的已知危险因素,估计黑色素瘤家族史与黑色素瘤和 KCs 之间的关联。
与没有黑色素瘤家族史的个体相比,有黑色素瘤家族史的个体患黑色素瘤的风险增加了 74%(风险比 [HR],1.74;95%置信区间 [CI],1.45-2.09),患鳞状细胞癌的风险增加了 22%(HR,1.22;95%CI,1.06-1.40),患基底细胞癌的风险增加了 27%(HR,1.27;95%CI,1.12-1.44)。黑色素瘤家族史增加了两性躯干黑色素瘤、女性肢端黑色素瘤和女性肢端鳞状细胞癌的发病风险。
本研究的局限性包括自我报告的家族史和检测偏倚。
有黑色素瘤家族史的个体患黑色素瘤和 KCs 的风险增加。