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Merkel Cell Carcinoma: Potentially Modifiable Risk Factors

By: Celeste L. Dixon
Posted: Wednesday, May 15, 2024

Ultraviolet (UV) radiation and Merkel cell polyomavirus play major roles in the development of Merkel cell carcinoma in the United States, according to the results of complex statistical calculations performed by Eric A. Engels, MD, MPH, of the National Cancer Institute, Rockville, Maryland, and colleagues. These results take into account that immunosuppressed patients who have received an organ transplant and those who have HIV have 13 and 3 times higher risk of Merkel cell carcinoma compared with the general population. Nonetheless, the team concluded that 65.8% and 66.1% of the 40,571 Merkel cell carcinomas diagnosed in this country between 2001 and 2020 may be attributed, at least in part, to UV radiation and Merkel cell polyomavirus. The researchers presented their work during the American Association for Cancer Research (AACR) Annual Meeting 2024 (Abstract 843/16).

The investigators strongly suggest further study to assess the combined impact of UV radiation and Merkel cell polyomavirus on Merkel cell carcinoma incidence. No previously published study, they noted, has estimated the contribution of major potentially modifiable risk factors—UV radiation and Merkel cell polyomavirus as well as immunosuppression—to the Merkel cell carcinoma burden in the United States.

Among their data sources were U.S. cancer registries in the HIV/AIDS Cancer Match Study and Transplant Cancer Match Study; the Surveillance Epidemiology and End Results (SEER) Program; and county-level measurements of ambient UV radiation levels. They calculated incidence rate ratios comparing the incidence of Merkel cell carcinoma in non-Hispanic White individuals with that in all other races and ethnicities, “since only non-Hispanic White individuals showed elevated incidence rate ratios for increased ambient UV radiation exposure.” The investigators said: “Compared with people in other racial/ethnic groups, the incidence rate ratios of non-Hispanic White individuals at the various levels of ambient UV radiation for Merkel cell carcinoma arising on the head and neck ranged from 4.24 to 5.03; for other primary sites, they ranged from 2.81 to 3.36.”

Disclosure: The study authors reported no conflicts of interest.

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