A RECENT study has revealed that adult survivors of childhood cancer face a significantly elevated risk of developing melanoma, underscoring the necessity for vigilant long-term monitoring and tailored preventive strategies.
The research, encompassing 25,716 participants from the Childhood Cancer Survivor Study cohort, identified 177 melanomas in 160 survivors, including 110 invasive cases, 62 in situ cutaneous cases, and five ocular cases. The 40-year cumulative incidence of melanoma was 1.1% (95% CI, 0.9 to 1.4) among all participants, rising to 1.5% (95% CI, 1.0 to 2.1) in those who received a cumulative radiation dose of ≥40 Gy. Notably, the standardized incidence ratio (SIR) for invasive skin or ocular melanoma was 2.0 (95% CI, 1.6 to 2.4) compared to the general population.
The study identified several treatment-related risk factors for melanoma. A cumulative radiation dose of ≥40 Gy to the corresponding body region(s) was associated with a two-fold increased risk (HR, 2.0 [95% CI, 1.1 to 3.7]). Similarly, a cumulative cyclophosphamide equivalent dose of ≥20,000 mg/m² (HR, 1.9 [95% CI, 1.1 to 3.6]) and exposure to bleomycin (HR, 2.2 [95% CI, 1.2 to 4.1]) were linked to a heightened risk of cutaneous melanoma.
Survivors diagnosed with invasive melanoma exhibited a more than two-fold increased risk of mortality (HR, 2.4 [95% CI, 1.7 to 3.3]). These findings highlight the critical importance of long-term surveillance and proactive management strategies for this vulnerable population.
This demonstrates the need for regular dermatologic assessments and patient education on skin health. Tailored screening protocols and preventive measures should be considered, especially for those exposed to high-dose radiation and specific chemotherapeutic agents during their childhood cancer treatment.
In conclusion, as survival rates for childhood cancer continue to improve, attention must shift toward mitigating long-term health risks such as melanoma.
Reference: Rotz SJ et al. Melanoma Among Adult Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study, J Clin Oncol. 2025. doi: 10.1200/JCO-24-01519.
Anaya Malik | AMJ
