The four Ws of skin cancer surveillance in patients with melanoma: Why? Who? When? Where?

A Dutch collaborative group of the Netherlands Comprehensive Cancer Organisation and Radboud University Medical Centre have investigated the risk factor profile of patients developing a subsequent melanoma to provide a more personalized follow-up regimen to patients with melanoma. 1 Of the 1127 participating patients with melanoma from the general population, 53 developed a subsequent melanoma during a median follow-up of 7.3 years. The cumulative 5-year risk of 3.7% is identical to the pooled estimate from a recent review and remained comparable in years 5-10 after their first diagnosis. 2 The risk factor analysis for subsequent melanoma in a relatively small sample (n = 53) showed that elderly patients with many naevi, professional ultraviolet radiation (UVR) exposure, and a first in situ melanoma are at the highest risk. The authors suggest that these subgroups require additional surveillance, but in contrast to other common cancers such as breast and colorectal cancer no specific survivorship care plan has been developed for patients with skin cancer including melanoma. (3,4)