Population differences in Merkel cell carcinoma by virus status and anatomic site: A multi-cohort analysis including institutional, SEER, and NCDB data - 18/02/26
Abstract |
Background |
The impact of race/ethnicity on Merkel cell carcinoma (MCC) outcomes remains inconclusive.
Objective |
To examine associations between MCC primary site, virus status, environmental ultraviolet radiation (UVR), and race/ethnicity.
Methods |
Patients diagnosed with MCC at the University of Washington (UW), in Surveillance, Epidemiology, and End Results (SEER-17), in National Cancer Database (NCDB), and global incidence and virus status data were included in this retrospective multi-cohort study. We estimated the prognostic effect of virus status using a Cox proportional hazards model, conducted a pooled analysis of tumor site and virus status, and investigated racial/ethnic differences in site using SEER and NCDB. We also estimated global MCC viral subtype incidences and assessed their association with geographic UV indices.
Results |
Virus-positive MCC (VP-MCC) showed improved survival compared to virus-negative MCC (VN-MCC) ( P < .001) and was more likely to develop on UV-protected skin ( P < .001). Black and Hispanic patient tumors were more likely to present on UV-protected sites ( P < .001). Globally, UVR had a bigger effect on VN-MCC incidence than VP-MCC.
Limitations |
Nonstandardized virus assays, unknown patient migration histories, incomplete global data, and registry selection bias.
Conclusion |
Black and Hispanic patients more often develop MCC on UV-protected sites, which are more likely VP-MCC and associated with improved outcomes.
Le texte complet de cet article est disponible en PDF.Key words : epidemiology, healthcare disparities, Merkel cell carcinoma, Merkel cell polyomavirus, oncology, ultraviolet radiation
Abbreviations used : AAPI, ddPCR, MCC, MCPyV, NCDB, OMI, PCR, qPCR, SEER, UV, UVR, UW, VN, VP
Plan
| Authors Martin and Vilasi are co-first authors. |
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| Funding sources: This research was supported by the Intramural Research Program , National Institute of Arthritis and Musculoskeletal and Skin Diseases ( ZIA AR041222 to I.B.). The contributions of the NIH authors were made as part of their official duties as NIH federal employees, comply with agency policy, and are considered Works of the United States Government. However, the findings and conclusions presented in this paper are those of the authors and do not necessarily reflect the views of the NIH or the US Department of Health and Human Services. The funding source had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication. |
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| Portions of this study were presented at the Multicenter Merkel Interest Group; New Orleans, LA, March 17, 2023. |
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| Patient consent: No further consent was required for the use of the deidentified data utilized in this study. |
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| IRB approval status: The NIH Office of Human Subjects Research determined this study was exempt from IRB review. |
Vol 94 - N° 3
P. 852-858 - mars 2026 Retour au numéro
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