Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2022

Cutaneous melanoma, prostate specific antigen testing and the subsequent risk of prostate cancer diagnosis: a prospective analysis of the 45 and Up Study. (#47)

Sam Egger 1 , David P Smith 1 , Manish I Patel 2 , Michael G Kimlin 3 , Bruce K Armstrong 4 , Visalini Nair-Shalliker 1
  1. The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council New South Wales, Sydney, New South Wales, Australia
  2. The University of Sydney, Sydney, NSW
  3. Queensland University of Technology, Brisbane, Qld, Australia
  4. University of Western Australia, Perth, WA

Background

The association between cutaneous melanoma and subsequent risk of prostate cancer (PC) was examined in a large population-based cohort study.

Methods

Male participants in the Sax Institute’s 45 and Up Study (Australia) were recruited between 2006 and 2009. Questionnaire data and linked administrative health data from the Centre for Health Record Linkage and Services Australia identified melanomas diagnosed between 1/1/1994 and 12 months before Study recruitment (ie between 2005 and 2008), incident PC, primary health care utilisation and Prostate Specific Antigen (PSA) tests. Men were excluded from the current analyses if they had a recorded PC or other cancer diagnosis other than melanoma and non-melanoma skin cancer prior to recruitment. Multivariable Cox regression analysis, estimated hazard ratios (HRs), adjusting for PSA testing frequency before PC diagnosis.

Results

Of 96,548 eligible men, 1,899 were diagnosed with melanoma during the melanoma diagnosis period and 3,677 incident PC diagnosed during follow-up (latest date 31/12/2013). Men with melanoma diagnosis had increased risk of a subsequent PC diagnoses (versus no melanoma; fully-adjusted HR=1.32;95%CI:1.09-1.60). There was weak evidence of higher risks of a subsequent PC diagnosis for men diagnosed with more than one melanoma compared to men diagnosed with only one melanoma (p =0.077), and if first melanoma diagnosis was 10 to 15 years before Study recruitment (fully-adjusted HR=2.05;95% CI[1.35, 3.12]).

Conclusion

Melanoma diagnosis was associated with increased risk of subsequent PC diagnosis, after adjusting for PSA testing and primary health care utilisation. While our ability to adjust for PC screening reduced risk of detection bias, we acknowledge that residual confounding from increased medical surveillance after melanoma diagnoses cannot be entirely ruled out.