Identification of risk factors for acral melanoma in veterans

Summary: Abstract Body: This study investigates the risk factors associated with acral melanoma (AM) in the veteran population to address the lack of risk prediction models (RPM) for early detection of AM. AM cases were identified in the Veterans Affairs (VA) Cancer Registry (VACR) using ICD-10, ICD-O-3, and primary site codes. A natural language processing pipeline was also developed to identify AM from VA pathology notes. All identified cases were manually reviewed for accuracy. Cases were matched to CM and non-melanoma controls. Phenotypic and putative risk factor data were extracted, and AM associations compared to CM and non-melanoma controls were evaluated using univariate and multivariate logistic regression analyses. 1,304 AM cases were identified. Agent Orange exposure was associated with higher odds of AM (aOR 1.32, 95% CI: 1.08-1.62, p = 0.007) compared to non-melanoma controls. Current smoking was inversely associated with AM compared to both CM and non-melanoma controls (aOR 0.75, 95% CI: 0.63-0.89, p = 0.001, aOR 0.71, 95% CI: 0.60-0.85, p < 0.001). Lower body mass index (BMI) categories (underweight and normal BMI) were inversely associated with AM compared to overweight non-melanoma controls (aOR 0.76, 95% CI: 0.63-0.90, p = 0.002). We identified distinct clinical and environmental factors associated with AM in veterans, including increased odds with Agent Orange exposure and reduced odds with current smoking status and lower BMI. We will apply these findings to develop and validate an RPM in civilian populations to improve the early detection of AM. Jonathan C. Hwang¹, Linden Huhmann², Kelly Cho², Sergey D. Goryachev², Nicholas Starink⁵, Martin A. Weinstock³, Christy Zheng¹, Yevgeniy Semenov⁴, Marc S. Hurlbert⁵, Nathanael R. Fillmore², Rebecca I. Hartman¹ 1. Dermatology Section, VA Boston Healthcare System, Jamaica Plain, MA, United States. 2. VA Boston Health Care System Massachusetts Veterans Epidemiology Research and Information Center, Boston, MA, United States. 3. Center for Dermatoepidemiology, Providence VA Medical Center, Providence, RI, United States. 4. Massachusetts General Hospital, Boston, MA, United States. 5. Melanoma Research Alliance, Washington, DC, United States. Pigmentation, Melanoma, and Melanoma Immune Surveillance