Prospective risk of melanoma has decreased substantially in both mutation-positive and mutation-negative families over 4 decades, while melanoma has greatly increased in the general population, a recent study found. Researchers assessed risks of melanoma and other cancers in 1,226 members of 56 families followed for up to 4 decades to population rates in the Surveillance, Epidemiology, and End Results (SEER) program. All families were tested for mutations in CDKN2A and CDK4; 29 were mutation-positive and 27 mutation-negative. They compared rates of invasive melanomas, both first and second, by family mutation status, to SEER. Findings included:

• Comparing 3 calendar periods of the study, risk of first primary melanoma decreased slightly.
• Risks of melanoma after first examination, however, were approximately one-third the risks prior to the first examination, in both mutation-positive and mutation-negative families.
• Among patients with melanoma, risk of a second melanoma was increased 10-fold in all families; risk was somewhat higher in mutation-positive families.
• Risks of other second cancers were increased only for pancreatic cancer after melanoma in mutation-positive families.