Age‐specific melanoma risk associated with melanocytic nevi: a pooled analysis from the M‐SKIP project

Summary Objective This study investigates the association of melanoma risk with total‐body nevus count and the presence of atypical nevi in younger (< 40 years) and older (> 60 years) individuals. Methods A pooled analysis was conducted within the M‐SKIP project, based on multiple melanoma case‐control studies. Associations were assessed through study‐specific odds ratios (ORs), adjusted for potential confounders. Results Nine case‐control studies were included, analyzing common nevi (2,674 melanoma cases/2,343 controls) and atypical nevi (2,459 cases/1,740 controls). High common nevus count was associated with increased melanoma risk in both younger (summary [s]OR = 2.56; 95% CI 1.64‐4.01; I 2 = 31%) and older individuals (sOR = 2.06; 95% CI 1.06–4.00; I 2 = 67%), with no significant age‐group difference (p = 0.57). In contrast, younger individuals exhibited a markedly higher risk of melanoma associated with the presence of at least one atypical nevus (sOR = 4.84, 95% CI 2.18–10.76; I 2 = 65%) compared to older individuals (sOR = 1.71 95%CI 1.07–2.74; I 2 = 39%), with a p value for the difference of 0.02. Conclusions These findings suggest age‐specific differences in melanoma risk associated with nevus burden. Specifically, atypical nevi are a stronger risk factor in younger individuals. This could have significant implications for prevention strategies and clinical management, in particular for better identification of high‐risk groups for targeted secondary prevention efforts.