Second Primary Invasive Melanoma Rate in Queensland Reaches Plateau After Decades-Long Rise

A landmark study among more than 100,000 Queensland residents has revealed that while the incidence of developing second primary invasive cutaneous melanomas increased from the 1980s through the early 2000s, the rising trend has now begun to plateau. The reassuring findings of the new study in the Journal of Investigative Dermatology (JID), published by Elsevier, can be mainly attributed to the cumulative impact of long-running sun safety campaigns in Australia combined with increased surveillance.

Queensland, Australia has the highest incidence rates of invasive melanoma globally. Residents of Queensland with a personal history of invasive melanoma have previously been found to have a five-time higher risk of being diagnosed with a second primary invasive melanoma compared to other individuals in the population, posing an increased risk of mortality.

Until now, there has been a lack of comprehensive data relating to trends in the incidence of second primary melanomas. This study represents the first published evidence that the cumulative incidence of second primary invasive melanomas appears to be stabilizing in Queensland.

Using data from the Queensland Oncology Repository, managed and maintained by Cancer Alliance Queensland, researchers investigated changes in the cumulative incidence of second primary melanomas for 101,035 people diagnosed with a first primary invasive cutaneous melanoma between 1982-2022, with follow-up until the end of 2023. The majority of participants were male (n=58,350, 58%) and the overall median age at first diagnosis was 61 years.

“After accounting for other events (such as death) that could prevent a second primary invasive melanoma diagnosis, as well as the length of follow-up time available per person, we estimated that these individuals had a one in six likelihood of being diagnosed with a second primary invasive melanoma within 40 years of their initial diagnosis,” explains lead investigator Professor Mark Smithers, from the Queensland Melanoma Project, Princess Alexandra Hospital, and The University of Queensland, who chairs the Cancer Alliance Queensland subcommittee on melanoma.

“However, the risk changed over time—5% of people diagnosed with a first primary invasive melanoma between 1982-1991 were diagnosed with a second melanoma within 10 years, rising to a peak of almost 8% between 2002-2011 before decreasing slightly to just over 7% between 2012-2022.”

The recent trend coincides with the introduction of widespread sun safety campaigns from the early 1980s onwards, which were aimed at reducing exposure to UV light, combined with educating the public and healthcare providers about the appearance of and risks for developing melanomas.

Dr. Smithers notes, “It’s never too late to start protecting yourself. We believe that the impacts of this dual public health messaging have been the main reasons for slowing the incidence of invasive melanoma in Queensland and are now also starting to flow through to the stabilized incidence that we are seeing for second primary invasive melanomas.”

Other factors driving this trend may include improved skin cancer surveillance by practitioners, resulting in more melanomas being diagnosed before they become invasive and shifts in the demographic composition of the Queensland population towards lower risk skin types. According to the 2021 Census, 23% of people in Queensland were born overseas compared with 12% in 1971. This growing population subgroup is likely to have had less intense UV exposure during childhood than those who grew up in Queensland and/or darker skin complexions, both of which would lower the risk of multiple primary invasive cutaneous melanomas.

Dr. Smithers concludes, “While we are encouraged to see the stabilization of this trend, it is also a reminder that men and members of older age groups remain at the greatest risk of developing a second melanoma. Our findings underline the importance of continuing to advocate for physical methods of sun safety in the population and the value of continued public education campaigns focusing on sun safety and early recognition and diagnosis.”

JID Section Editor David E. Fisher, MD, PhD, Edward Wigglesworth Professor of Dermatology and Professor of Pediatrics, Harvard Medical School, Massachusetts General Hospital, observes, "This excellent study provides valuable evidence of good news for second primary melanomas, reinforcing trends on improvements seen for primary melanomas. Collectively these results suggest that changes in human behaviors can truly impact this deadly disease. Much of melanoma incidence should theoretically be preventable— an aspiration that was slow to attain but may finally be at hand."

Notes for editors

The article is “Second primary invasive cutaneous melanomas in Queensland over 4 decades,” by Danny R. Youlden, Victoria Atkinson, Mark B. Pinkham, Andrew Barbour, Wen Xu, Kiarash Khosrotehrani, Melissa Eastgate, Megan Lyle, Solange Green, Artika Nath, Theresa Negrello, Danica Cossio, and B. Mark Smithers (https://doi-org.ucc.idm.oclc.org/10.1016/j.jid.2026.01.026). It appears online in the Journal of Investigative Dermatology, published by Elsevier.

The article is openly available for 30 days at https://www.jidonline.org/article/S0022-202X(26)00075-8/fulltext.

The full text of the article is also available to credentialed journalists upon request; contact Eileen Leahy at +1 732 406 1313 or [email protected]. Journalists wishing to interview the authors should contact Professor Mark Smithers at +61 412 073 422 or [email protected].

About the Journal of Investigative Dermatology

The Journal of Investigative Dermatology (JID) is the official journal of the Society of Investigative Dermatology and the European Society for Dermatological Research. JID publishes high impact reports describing original research related to all aspects of cutaneous biology and skin diseases. Descriptions of important findings that result from basic, translational, or clinical research are published. Clinical research can include, but is not limited to, interventional trials, genetics studies, epidemiology, and health services research. www.jidonline.org

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