Risk for developing a subsequent primary melanoma was associated with presence of many nevi, according to results of a population-based prospective cohort study, published in JAMA Dermatology.

The risk for a second primary melanoma is assumed to be associated with history of a first primary melanoma; however, to date, no formal analysis of whether certain patients are at increased risk has been published.

To evaluate predictors for second primary melanoma, investigators from QIMR Berghofer Medical Research Institute in Australia sourced data from the QSkin Sun and Health Study, which randomly sampled adults aged 40 to 69 years between 2010 and 2011 from the electoral roll in Queensland (N=38,845). Diagnoses of primary melanoma were evaluated through 2018.

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The study population comprised 21,070 women and 17,775 men, mean age 56.1 years at baseline.

During a median follow-up of 7.4 years, 3.1% had 1 primary melanoma diagnosis and 0.6% had 2 or more primary melanoma diagnoses. The median time to first primary melanoma diagnosis was 48.0 months and from first to second was 18.4 months.

In the fully adjusted analysis, second primary melanoma was associated with many (adjusted hazard ratio [aHR], 6.36), some (aHR, 3.58), or a few (aHR, 1.45) moles compared with no moles; a tendency to burn badly (aHR, 2.01) compared with no burning; a few (aHR, 1.98) or some (aHR, 1.66) freckles compared with no freckles; 6 to 20 (aHR, 1.68) or more than 20 (aHR, 1.63) past skin lesions destroyed; 1 (aHR, 1.67) or 2 or more (aHR, 2.63) prior skin cancer excisions; and a family history of melanoma (aHR, 1.36).

The results of this study may not be generalizable for a population living outside Australia.

These data indicated that risk for second primary melanoma was associated with presence of moles, having freckles, skin cancer history, and family history.

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.


Olsen CM, Pandeya N, Dusingize JC, et al; the QSkin Study. Risk factors associated with first and second primary melanomas in a high-incidence population. JAMA Dermatol. Published online November 23, 2022. doi:10.1001/jamadermatol.2022.4975