{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T02:10:44Z","timestamp":1779934244916,"version":"3.53.1"},"reference-count":65,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T00:00:00Z","timestamp":1691625600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["2008454"],"award-info":[{"award-number":["2008454"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100015626","name":"Melanoma Institute Australia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100015626","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Compared with the general population, people with a previous melanoma are at increased risk of developing another primary melanoma. Understanding the risk factors associated with multiple primary melanomas can inform patient education and tailored surveillance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To examine the risk factors for subsequent primary melanoma in people with a previous melanoma, by conducting a systematic review and meta-analysis of the available data.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A systematic literature search was conducted in CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), Embase and MEDLINE. Studies that reported a risk estimate or raw frequencies and conducted between 1982 and August 2022 were included. Adjusted risk estimates were prioritized over univariable risk estimates. PRISMA reporting guidelines were followed. Random effects meta-analysis was conducted to derive pooled estimates. Quality assessment was conducted by two researchers using the Newcastle-Ottawa scale. GRADE was used to rate the certainty and quality of the evidence.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Data from 27 studies involving 413 181 participants were pooled and analysed. Risk factors assessed included age and sex, environmental, lifestyle, phenotypic, genetic and histopathological factors, and there was wide variation in how they were categorized and analysed. Independent risk factors identified from pooled analyses included male sex [hazard ratio (HR) 1.46, 95% confidence interval (CI) 1.40\u20131.53], increasing age per 10\u2005years (HR 1.19, 95% CI 1.14\u20131.24), light skin colour (HR 1.44, 95% CI 1.23\u20131.70), family history [odds ratio (OR) 1.79, 95% CI 1.25\u20132.56], CDKN2A mutation (OR 5.29, 95% CI 2.70\u201310.37), a high or moderate naevus count [OR 2.63 (95% CI 1.61\u20134.30) and OR 1.64 (95% CI 1.07\u20132.51), respectively], one or more atypical naevi (OR 3.01, 95% CI 1.52\u20135.97), first lesions occurring on the head or neck, lentigo maligna subtype (HR 1.16, 95% CI 1.15\u20131.17), other subtype (HR 1.14, 95% CI 1.03\u20131.27) and inadequate sun protection (HR 1.85, 95% CI 0.98\u20133.50). Based on the GRADE criteria, there was high to very low confidence in the pooled effect estimates.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This meta-analysis identified several consistent, independent risk factors for the development of subsequent primary melanoma. These findings will help stratify the risk of subsequent melanoma, tailor skin-check schedules and inform patient education.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjd\/ljad275","type":"journal-article","created":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T12:52:50Z","timestamp":1691585570000},"page":"174-183","source":"Crossref","is-referenced-by-count":18,"title":["Risk factors for subsequent primary melanoma in patients\u00a0with previous melanoma: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"190","author":[{"given":"Juliet","family":"Smith","sequence":"first","affiliation":[{"name":"The Daffodil Centre, The University of Sydney , a joint venture with Cancer Council NSW, Sydney , Australia"},{"name":"Melanoma Institute Australia"},{"name":"Sydney School of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5331-6370","authenticated-orcid":false,"given":"Anne E","family":"Cust","sequence":"additional","affiliation":[{"name":"The Daffodil Centre, The University of Sydney , a joint venture with Cancer Council NSW, Sydney , Australia"},{"name":"Melanoma Institute Australia"},{"name":"Sydney School of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5092-5544","authenticated-orcid":false,"given":"Serigne N","family":"Lo","sequence":"additional","affiliation":[{"name":"Melanoma Institute Australia"},{"name":"Faculty of Medicine and Health, The University of Sydney , Sydney , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,8,10]]},"reference":[{"key":"2024090210030478800_ljad275-B1","author":"Cancer Council"},{"key":"2024090210030478800_ljad275-B2","author":"Australian Government, Cancer Australia"},{"key":"2024090210030478800_ljad275-B3","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1200\/JCO.2016.68.4308","article-title":"Cost-effectiveness of skin surveillance through a specialized clinic for patients at high risk of melanoma","volume":"35","author":"Watts","year":"2017","journal-title":"J Clin Oncol"},{"key":"2024090210030478800_ljad275-B4","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1111\/bjd.18524","article-title":"A risk prediction model for the development of subsequent primary melanoma in a population-based cohort","volume":"182","author":"Cust","year":"2019","journal-title":"Br J Dermatol"},{"key":"2024090210030478800_ljad275-B5","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1111\/jdv.12887","article-title":"Risk of subsequent cutaneous malignancy in patients with prior melanoma: a systematic review and meta-analysis","volume":"29","author":"Van der Leest","year":"2015","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2024090210030478800_ljad275-B6","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1007\/s10434-999-0705-0","article-title":"Increased incidence of second primary melanoma in patients with a previous cutaneous melanoma","volume":"6","author":"Di Fronzo","year":"1999","journal-title":"Ann Surg Oncol"},{"key":"2024090210030478800_ljad275-B7","first-page":"84","article-title":"A\u00a0meta-analysis on major risk factors of multiple primary cutaneous melanomas","volume":"2","author":"Marasigan","year":"2014","journal-title":"Clin Dermatol"},{"key":"2024090210030478800_ljad275-B8","doi-asserted-by":"crossref","first-page":"105906","DOI":"10.1016\/j.ijsu.2021.105906","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"88","author":"Page","year":"2021","journal-title":"Int J Surg"},{"key":"2024090210030478800_ljad275-B9","author":"Wells"},{"key":"2024090210030478800_ljad275-B10","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1186\/1471-2458-13-154","article-title":"Are healthcare workers\u2019 intentions to vaccinate related to their knowledge, beliefs and attitudes? 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