Genetics Play a Larger Role in Melanoma Than Previously Thought

A person’s genetics play a more prominent role in melanoma than previously believed, according to a study published in the Journal of the American Academy of Dermatology.

Physicians typically do not order genetic screens to assess risk factors for patients with a family history of melanoma because, according to limited previous studies, only 2.0% to 2.5% of all cases are genetic. Therefore, insurance companies rarely cover these tests outside of extreme circumstances. However, the findings of this study painted a different picture.

The analysis comprised 400 individuals with melanoma diagnosed between 2017 and 2020 who had a personal or family history of cancer. All patients underwent germline testing of more than 80 cancer predisposition genes. Comparative analysis of germline data was performed on 3 additional oncologic and dermatologic data sets, the researchers noted.

Melanoma Risk Goes Beyond Sun Exposure

According to the results, up to 15% (1 in 7) of patients who received a melanoma diagnosis carried mutations in cancer susceptibility genes. “Hereditary cancers can wreak havoc through families and leave devastation in their wake. Genetic testing lets us proactively identify, screen, and even treat these families to equip them with the tools they need to get the best health care possible,” said Joshua Arbesman, MD, of the Cleveland Clinic and one of the study’s lead researchers, via a press release. “I would recommend physicians and insurance companies expand their criteria when it comes to offering genetic testing to individuals with family histories of melanoma, because inherited predisposition to it isn’t nearly as rare as we think it is.”

According to Dr. Arbesman, the study highlights that there are risk factors beyond sun exposure that can influence a person’s chances of developing melanoma, but he cautioned that the findings need to be elucidated. “Not all of my patients had inherited mutations that made them more susceptible to the sun,” he says. “There’s clearly something more going on here, and more research is needed.”