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Recent findings suggest a previous melanoma diagnosis is a risk factor for all patients -- regardless of race and ethnicity.

Authors of the report, which appeared in , wrote that while melanoma is less common among racial and ethnic minority populations than in white patients, "individuals in these groups with a first melanoma diagnosis have a rate of second primary melanoma diagnosis comparable to that of white patients."

Investigators examined data from 546,756 patients with first primary melanoma diagnosis. Of these patients, 0.2% had American Indian or Alaska Native, 0.6% had Asian or Pacific Islander, 0.4% had Black, 3.1% had Hispanic, and 96% had white race and ethnicity.

Compared with the general population, Black patients had the highest relative risk of second primary melanoma (IR 264; 95% CI 211-327), followed by Asian or Pacific Islander, Hispanic, American Indian or Alaska Native, and white patients. White patients had the highest absolute numbers of excess second primary melanomas per 100,000 person-years (IR 1,332; 95% CI 1,319-1,346).

Study co-author Adewole Adamson, MD, is a dermatologist and assistant professor with the department of internal medicine at The University of Texas at Austin Dell Medical School. His exchange with the Reading Room has been edited for length and clarity.

What knowledge gap was this investigation designed to address?

Adamson: Although patients with melanoma are known to be at increased risk of developing a subsequent melanoma, little definitive information exists on the magnitude of the risk.

In particular, there was little information on how that risk differs by race and ethnicity. While research has focused on measures of relative risk, less is known about the absolute risk of second primary melanoma across race and ethnicity. This is important in being able to counsel patients.

What were your key findings?

Adamson: The incidence of second melanomas happens at different rates depending on racial or ethnic group.

While we found elevated relative risks of second primary melanoma among racial and ethnic minority groups versus the general population, measures of absolute risk were far less substantial, illustrating that reporting only relative measures, as done previously, is potentially misleading.

Did anything about the study findings surprise you?

Adamson: I was surprised that Black patients had such a high risk of developing a second melanoma. I thought this phenomenon would be rarer than the data showed.

What are the key take-home messages for dermatologists?

Adamson: Regardless of race, if a patient is diagnosed with melanoma they should continue to have follow-ups because they are at increased risk for a second melanoma.

Looking into the future, how might these findings help inform or improve dermatology care?

Adamson: This study has implications for how we should counsel patients across racial and ethnic groups about the need for follow-up skin examinations after a diagnosis of melanoma.