Number of Cutaneous Nevi Associated With Mortality Risk in Melanoma, Particularly for Men

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Previous studies have demonstrated an association between number of melanocytic nevi and increased risk of developing melanoma.
Previous studies have demonstrated an association between number of melanocytic nevi and increased risk of developing melanoma.

According to results from a prospective, epidemiologic study of 3 cohorts from the Nurses' Health Study (NHS) I and II and the Health Professionals Follow-up Study (HPFS), a high cutaneous melanocytic nevi count was significantly associated with increased risk of melanoma death, with a stronger association observed in men compared with women. This study was published in the Journal of the American Academy of Dermatology

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Although previous studies have demonstrated an association between number of melanocytic nevi and increased risk of developing melanoma, whether the likelihood of death from melanoma increases with increasing number of nevi remains unclear. 

This study included 77,288 women from NHS and 32,455 men from HPFS. Between 1986 and 2012, 2452 cases of melanoma and 196 melanoma deaths were reported. In the overall cohort, a higher number of nevi was associated with increased melanoma death for both men and women (hazard ratio [HR] for 3 or more nevi vs 0 was 2.49 [95% CI, 1.50-4.12] in women and 3.97 [95% CI, 2.54-6.22] for men) after adjusting for potential confounders such as race, Breslow thickness, and site of melanoma on body. However, analyses of only melanoma cases, also adjusted for the same confounders, showed that the HR (95% CI) for melanoma death was 1.13 (0.69-1.83) for 1-2 nevi and 0.98 (0.60-1.59) for 3 or more nevi in NHS (= .49), and 1.42 (0.83-2.44) for 1-2 nevi and 1.90 (1.17-3.09) for 3 or more nevi in HPFS (= .004) compared with no nevi. 

“Further studies are warranted to confirm the differential associations of nevi counts with melanoma prognosis by gender and to elucidate the underlying mechanisms,” the authors concluded. 

Li WQ, Cho E, Weinstock MA, Li S, Stampfer MJ, Quershi AA. Cutaneous nevi and risk of melanoma death in women and men: a prospective study[published online January 10, 2019]. J Am Acad Dermatol. doi: 10.1016/j.jaad.2018.12.058

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