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Soo Park, MD
Soo Park, MD
Posted: Thursday, February 13, 2025
A new study published by Seth J. Rotz, MD, of Cleveland Clinic Children’s Hospital, and colleagues in the Journal of Clinical Oncology revealed that adult survivors of childhood cancer face more than double the risk of developing melanoma compared with the general population. The findings emphasize the long-term consequences of cancer therapies.
“In our study, those receiving more than 40 Gy to a target area have a significantly increased risk of melanoma. Previous reports have demonstrated a strong relationship between radiation and non-melanoma skin cancer, but, to our knowledge, this is the first to demonstrate an increased risk of melanoma,” the investigators reported. Given melanoma’s long latency, an average of 26.4 years after initial cancer diagnosis, they recommended dermatologic screening be deferred until adulthood.
Drawing from the Childhood Cancer Survivor Study—the largest study of its kind—researchers analyzed data from 25,716 participants diagnosed with childhood cancer in the United States and Canada between 1970 and 1999. This comprehensive retrospective cohort included survivors diagnosed before the age of 21 with cancers such as leukemia, lymphoma, central nervous system cancer, renal cancer, neuroblastoma, rhabdomyosarcoma, or bone cancer. To better understand treatment-related risks, the analysis integrated data on radiation exposure across seven body regions and melanoma diagnoses for eight specific body areas.
In the cohort, 160 survivors developed melanoma, with a 40-year cumulative incidence of 1.1%, slightly bumping to 1.5% among those exposed to at least 40 Gy of radiation. Survivors who received at least 40 Gy of radiation to melanoma-associated regions had a hazard ratio of 2.0, demonstrating the dose-dependent relationship between radiation therapy and melanoma risk. Furthermore, a cumulative cyclophosphamide equivalent dose of at least 20,000 mg/m2 and exposure to bleomycin were independently associated with increased melanoma risk, with hazard ratios of 1.9 and 2.2, respectively. Cancer survivors diagnosed with invasive melanoma exhibited a significantly higher mortality risk, with a hazard ratio of 2.4, highlighting the potential need for enhanced preventive strategies and monitoring in this population.
Disclosure: Dr. Rotz reported no conflicts of interest. For full disclosures of the other study authors, visit ascopubs.org.
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