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Merkel cell carcinoma and multiple primary cancers.

Regan A Howard1, Graça M Dores, Rochelle E Curtis

  • 1Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Bethesda, MD 20892-7238, USA. reganho@mail.nih.gov

Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology
|August 10, 2006
PubMed
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Merkel cell carcinoma (MCC) patients have an increased risk of developing other cancers, especially within the first year. MCC also frequently follows other cancers, particularly lymphohematopoietic malignancies, suggesting shared causes.

Area of Science:

  • Oncology
  • Epidemiology
  • Dermatology

Background:

  • Merkel cell carcinoma (MCC) is an aggressive skin cancer with largely unknown causes.
  • Understanding cancer associations may reveal etiological factors for MCC.
  • Previous studies have not extensively quantified risks of subsequent cancers after MCC.

Purpose of the Study:

  • To estimate the long-term risk of subsequent primary cancers after a first primary MCC.
  • To assess the risk of developing MCC as a second primary malignancy after other initial cancers.

Main Methods:

  • Utilized data from 11 population-based cancer registries (1986-2002) from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program.
  • Analyzed 1,306 patients with a first primary MCC and 2,048,739 patients with other first primary cancers.

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  • Calculated standardized incidence ratios (SIR) and 95% confidence intervals (95% CI) to assess cancer risks.

    • Main Results:

    • Patients with MCC had a significantly increased risk of subsequent cancers (SIR=1.22), particularly in the first year post-diagnosis (SIR=1.71).
    • Elevated risks were observed for salivary gland, biliary, and non-Hodgkin lymphoma.
    • A 1.36-fold increased risk of MCC as a second primary malignancy was found, with notable excesses following multiple myeloma, chronic lymphocytic leukemia, non-Hodgkin lymphoma, and malignant melanoma.

    Conclusions:

    • MCC is associated with an increased risk of subsequent cancers, suggesting shared etiological influences.
    • The reciprocal increased risk of MCC following other cancers, especially lymphohematopoietic malignancies, warrants further investigation.
    • Heightened awareness of these associations may aid in the early clinical recognition of MCC.