On the roles of solar UV irradiance and smoking on the diagnosis of second cancers after diagnosis of melanoma

Figures & data

Table 1. Cancers after diagnosis of melanoma—historical results

Cancer	Sex	SIR (95% CI)	Location	Reference
Bone		6.08*	Italy	10
Brain, nervous system		Increase	Denmark	1
Breast	F	1.02 (0.87–1.20)	Sweden	11
CLL		Increase	Denmark	1
CLL		2.3 (1.1–4.4)	Scotland	12
Colon		1.33 (1.00–1.74)	Sweden	11
Endometrial		1.41 (1.03–1.88)	Sweden	11
Kidney	M	2.14 (0.97–4.97)	Taiwan	13
Kidney		1.95*	Italy	10
Nervous system	M	1.73, (1.10–2.60)	Sweden	11
	F	2.03 (1.45–2.78)	Sweden	11
Noncutaneous	F	Not significant	Taiwan	13
NHL		2.0 (0.5–5.0)	Switzerland	14
NHL		1.42 (1.23–1.63)	Hong Kong	15
NHL		1.5 (0.0–2.4)	Scotland	12
NHL	M	1.91 (0.88–3.62)	Taiwan	13
Ovary	F	1.06 (0.75–1.46)	Sweden	11
Pancreatic		Not significant	Denmark	1
Prostate	M	1.7 (1.5–2.0)	Switzerland	15
Decreased
Liver		0.46*	Italy	10
Lung		0.71*	Italy	10

* Statistically significant; CLL, chronic lymphocytic leukemia; NHL, non-Hodgkin lymphoma

Table 2. Melanoma after diagnosis of cancer

Cancer	SIR (95% CI)	Location	Reference
CLL	3.1 (2.1–4.4)	Sweden	2
CLL	2.3 (0.0–2.4)	Scotland	12
NHL	2.4 (1.8–3.2)	Sweden	2
NHL	1.75 (1.48–2.07)	Hong Kong	15
NHL	2.1	Scotland	12
Ocular melanoma	2.38 (1.77–3.14)	International	16

CLL, chronic lymphocytic leukemia; NHL, non-Hodgkin lymphoma

Table 3. Standardized incidence ratios (SIRs) after diagnosis of melanoma from the literature

Cancer	Melanoma, sunny countries, SIR (95% CI)^3	Melanoma, less sunny SIR (95% CI)^3	Melanoma (overall O:E), SIR (95% CI)^4	Melanoma, SIR (95% CI)^5	Melanoma, in situ SIR^6	Melanoma, invasive SIR^6
All sites			1.28 (1.26–1.30)	1.32 (1.30–1.34)	1.32	1.57
All solid, less skin, lip	1.03 (0.99–1.08)	1.14 (1.11–1.17)
All solid less skin, lip, lung	1.07	1.11
Vitamin D sensitive
Brain, nervous system	1.10 (0.80–1.47)	1.72 (1.45–2.02)		1.31 (1.13–1.51)
Breast, female	1.03 (0.92–1.15)	1.26 (1.18–1.33)	1.10 (1.04–1.16)	1.07 (1.02–1.12)
Chronic lymphocytic leukemia			1.20 (1.00–1.42)	1.29 (1.10–1.50)	1.44	1.57
Corpus uteri	1.14 (0.85–1.51)	1.12 (0.97–1.29)		0.90 (0.79–1.01)
Intestine, small			1.46 (1.08–1.92)	1.30 (0.98–1.69)
Non-Hodgkin lymphoma			1.25 (1.14–1.37)	1.25 (1.15–1.35)	1.21	1.56
Other female genital	0.89 (0.43–1.64)	0.84 (0.57–1.19)
Ovary	0.90 (0.62–1.26)	1.10 (0.95–1.27)		0.91 (0.77–1.07)
Prostate	1.20 (1.10–1.30)	1.31 (1.23–1.40)	1.15 (1.10–120)	1.13 (1.09–1.17)	1.24	1.15
Stomach	0.94 (0.75–1.16)	0.94 (0.83–1.06)		1.01 (0.88–1.16)
Thyroid			1.75 (1.50–2.04)	1.90 (1.65–2.17)	1.27	2.67
Smoking and vitamin D
Bladder	0.83 (0.67–1.02)	1.05 (0.94–1.18)		1.01 (0.94–1.09)
Cervix uteri				0.57 (0.41–0.78)
Colon				0.99 (0.94–1.06)
Colorectal	1.13 (1.03–1.23)	1.13 (1.06–1.21)			0.87	0.98
Esophagus	0.81 (0.54–1.15)	0.85 (0.64–1.11)		0.78 (0.63–0.94)
Kidney	1.35 (1.10–1.64)	1.25 (1.08–1.43)	1.28 (1.13–1.44)	1.29 (1.16–1.44)	1.20	1.47
Larynx				0.58 (0.45–0.73)
Pancreas	0.79 (0.60–1.03)	1.08 (0.94–1.24)		0.90 (0.79–1.01)
Rectum				0.91 (0.82–1.00)
Smoking related, little or unknown vitamin D
Hypopharynx				0.54 (0.29–0.90)
Leukemia, nonlymphocytic				0.78 (0.66–0.93)
Liver				0.77 (0.60–0.97)
Liver, gallbladder, bile ducts	0.61 (0.41–0.89)	0.80 (0.65–0.97)
Lung, bronchus, trachea	0.85 (0.76–0.95)	0.87 (0.80–0.95)		0.83 (0.79–0.88)	0.68	0.76
Myeloid, monocytic leukemia				0.82 (0.68–0.98)
Pharynx	0.86 (0.53–1.33)	0.67 (0.42–1.03)		0.61 (0.40–0.88)
Unknown vitamin D sensitivity
Bones and joints				1.70 (1.05–2.59)
Soft tissue sarcoma			2.00 (1.61–2.46)	2.80 (2.38–3.27)
UV sensitive
Lip				1.26 (0.94–1.65)
Melanoma			8.61 (8.31–8.92)	8.99 (8.71–9.28)	8.43	12.50
Ocular melanoma			1.77 (1.13–1.44)	2.64 (1.93–3.54)
Salivary gland			1.89 (1.38–2.52)	2.18 (1.69–2.77)
Nonepithelial skin				2.31 (1.87–2.83)

Bold, statistically significant

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