Researchers in Western Australia looked at 23 ,625 people who underwent treatment for a pterygium and found they had a 24% increased risk of developing cutaneous melanoma (CM) compared with controls (matched by age, sex and residential postcode) without a history of pterygium.

Based on recent findings, the International Agency for Research on Cancer determined that solar ultraviolet radiation exposure causes cutaneous malignant melanoma, according to the study. With this new causal relationship, the researchers sought to use whole population health data sets to investigate whether pterygia, also associated with solar ultraviolet radiation exposure, can serve as an early indication of an increased risk of a future CM diagnosis.

The study findings identify pterygia as a novel risk marker that is evident long before the development of CM, possibly saving lives with early screenings, diagnosis and treatment. The authors note roughly 15% of CMs are fatal, and regular screening and early detection are key to increased survival rates. While early detection of CM is a must, so is early detection of pterygia, according to further findings. Results show that every year increase in age at the time of the pterygium treatment had a 2% increase in the odds of developing a CM.

The researchers found race and sex can also play a role in overall risk, as women were 28% less likely than men to have a CM diagnosis, and a previous study did not find a similar correlation between CM and pterygium in a Taiwanese population. Based on the new data of Western Australian population, the researchers found the risk of developing a CM is 85 times greater in a Caucasian population than that reported in the Taiwanese cohort.
“Eye care providers who see patients with developing pterygia should advise these patients of this increased risk and recommend regular skin surveillance,” the study authors concluded.

Crewe JM, Threlfall T, Clark A, et al. Pterygia are indicators of an increased risk of developing cutaneous melanomas. Br J Ophthalomol. 2018;102(4):496-501.