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Soo Park, MD
Soo Park, MD
Posted: Wednesday, January 8, 2025
According to Karena D. Volesky-Avellaneda, PhD, of the National Cancer Institute, National Institutes of Health, Rockville, Maryland, and colleagues, there are major potentially modifiable risk factors that contribute to the burden of Merkel cell carcinoma in the United States. These investigators aimed to quantify the population attributable fraction of Merkel cell carcinoma cases that were derived from immunosuppressive conditions such as human immunodeficiency virus (HIV), chronic lymphocytic leukemia (CLL), ultraviolet (UV) radiation exposure, Merkel cell polyomavirus, and solid organ transplantation. Their results were published in JAMA Dermatology.
“The results of this study suggest that most Merkel cell carcinoma cases in the United States were attributable to ambient UV radiation exposure or Merkel cell polyomavirus, with a small fraction due to immunosuppressive conditions,” the authors concluded. “Future studies should investigate UV radiation mutational signature, tumor mutational burden, and Merkel cell polyomavirus prevalence according to race and ethnicity and patient immune status to help clarify the overlap between Merkel cell carcinoma risk factors.”
This retrospective study focused on 38,020 cases of Merkel cell carcinoma in the United States, with most patients being male (62%) and non-Hispanic White (93%). The incidence of Merkel cell carcinoma appeared to be elevated among patients with HIV and CLL when compared with the general population. Because these conditions are considered rare, 1.5%, 0.8%, and 0.2% of Merkel cell carcinoma cases were attributed to solid organ transplantation, CLL, and HIV, respectively.
The incidence of Merkel cell carcinoma of the head and neck appeared to be more frequent among patients who were non-Hispanic White compared with other racial and ethnic minority groups, regardless of ambient UV radiation exposure levels. It was found that UV radiation (65.1%) was the main cause of Merkel cell carcinoma, and 63.8% of Merkel cell carcinoma cases were attributed to Merkel cell polyomavirus, according to a meta-analysis of a 19-case series.
Disclosure: The study authors reported no conflicts of interest.
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