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BACKGROUND: Genetic and environmental risk factors have been associated with the development of multiple primary melanomas (MPM).
Multiple primary melanomas occurred in an eighth of this patient population.
In the latter family (FAM1), the proband developed multiple primary melanomas.
Ten per cent of patients with metastatic melanoma have a history of multiple primary melanomas (Murali et al, 2012).
These patients include those who had multiple primary melanomas (MPM), melanoma associated with another cancer, melanoma developing at a young age, or nonphoto-induced melanomas (NPIM).
Analysis of Swedish patients with multiple primary melanomas and NST was negative for the CDKN2A founder mutation 113insArg, which usually explains all CDKN2A-associated familial melanoma in Sweden (Nielsen et al, 2004).
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DNA samples from 1189 individuals with incident multiple primary melanoma (MPM) and 2424 with incident single primary melanoma unselected for family history of melanoma were available for screening of CDKN2A (p16INK4a) mutations.
Seven patients (8%) had a total of seven different germline changes in INK4a-ARF, in three melanoma kindreds, and four sporadic melanomas (one melanoma associated with a pancreatic cancer, one melanoma occurring before the age of 25 years, one multiple primary melanoma, and one melanoma localised to nonphoto-exposed skin).
Patients were categorised into five different melanoma subgroups: (a) familial melanoma (FAM, 23 cases), (b) multiple primary melanoma (MPM, 18 cases), (c) melanoma and additional unrelated cancers (13 cases), (d) age at diagnosis less than 25 years (21 cases), and (e) nonphoto-induced melanoma (NPIM, 14 cases).
We excluded 49 articles for the following reasons: duplicate populations (N = 20), no data on outcome (case/control status or any of the studied phenotypic characteristics) or on MC1R variants (N = 12), case reports, commentaries or reviews (N = 6), GWAS (N = 6), populations selected for genetic factors (N = 4) and multiple primary melanoma cases only (N = 1).
Permanent exclusion criteria were: 1) populations selected for MC1R status or for other genetic factors, 2) studies including only familial and/or multiple-primary melanoma cases, because we wanted to study MC1R-melanoma association at a population level, therefore excluding cases for whom the role of genetics is probably stronger.
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