Background

The presence of nevi portends an increased risk for melanoma.

Objective

We sought to examine the association between extremity nevus count and the risk of melanoma and keratinocyte cancers.

Methods

We evaluated prospective cohorts of 176,317 women (the Nurses' Health Study, 1986-2012 and the Nurses’ Health Study 2, 1989-2013) and 32,383 men (Health Professionals Follow-up Study, 1986-2012). Information on nevus count (none, 1-5, 6-14, ≥15) on the extremity was collected at baseline.

Results

There were 1704 incident cases of melanoma, 2296 incident cases of squamous cell carcinoma, and 30,457 incident cases of basal cell carcinoma, with a total of 4,655,043 person-years for melanoma and 4,267,708 person-years for keratinocyte cancers. The presence of an extremity nevus was associated with an increased risk of melanoma in all anatomic areas and increased risk of basal cell carcinoma (BCC). Individuals with ≥15 nevi had the highest risk of melanoma and BCC compared to those without any extremity nevi (melanoma hazard ratio 2.79 [95% confidence interval 2.04-3.83]; BCC HR 1.40 [95% confidence interval 1.32-1.49]). No significant association was observed for squamous cell carcinoma.

Limitations

Limitations of our study included self-reported nevus count and detection bias.

Conclusions

Extremity nevus count is a helpful clinical marker in risk-stratifying individuals for BCC and melanoma on all body sites.

中文翻译：

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肢端痣计数是基底细胞癌和黑色素瘤的独立危险因素，但不是鳞状细胞癌的独立危险因素

背景

痣的存在预示着黑色素瘤的风险增加。

客观的

我们试图检查四肢痣计数与黑色素瘤和角质形成细胞癌的风险之间的关联。

方法

我们评估了176,317名女性（1986-2012年《护士健康研究》和1989-2013年《护士健康研究2》）和32,383名男性（1986-2012年健康专业人员跟进研究）的前瞻性队列。在基线时收集有关四肢痣计数的信息（无，1-5、6-14，≥15）。

结果

黑色素瘤事件1704例，鳞状细胞癌事件2296例，基底细胞癌事件30457例，黑色素瘤事件总计4,655,043人年，角质形成细胞癌事件总计4,267,708人年。四肢痣的存在与所有解剖区域黑色素瘤的风险增加以及基底细胞癌（BCC）的风险增加有关。与没有任何末端痣的人相比，具有≥15个痣的人的黑素瘤和BCC风险最高（黑素瘤危险比2.79 [95％可信区间2.04-3.83]； BCC HR 1.40 [95％可信区间1.32-1.49]）。鳞状细胞癌未见明显关联。

局限性

我们研究的局限性包括自我报告的痣计数和检测偏倚。

结论

肢端痣计数是对所有部位的BCC和黑色素瘤进行风险分层的个人有用的临床指标。