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Pterygia are indicators of an increased risk of developing cutaneous melanomas
  1. Julie M Crewe1,
  2. Tim Threlfall2,
  3. Antony Clark1,
  4. Paul G Sanfilippo3,
  5. David A Mackey1
  1. 1Lions Eye Institute, Centre for Ophthalmology and Vision Science, University of Western Australia, Nedlands, Australia
  2. 2Department of Health, Western Australian Cancer Registry, Western Australia, Australia
  3. 3Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
  1. Correspondence to Julie M Crewe, Lions Eye Institute, 2 Verdun Street, Nedlands, Perth, Western Australia 6148; juliecrewe{at}


Aim To investigate whether pterygium is an indicator of an increased risk of cutaneous melanoma (CM).

Methods A matched-cohort study, using linked health administrative data sets to identify all hospital-treated pterygium in Western Australia (WA) between 1979 and 2014. We identified pterygium cases from hospital diagnosis and/or procedure International Classification of Diseases 9th revision (ICD-9) and 10th revision (ICD-10) codes and matched cases by age, sex and residential postcode to WA Electoral Roll controls with no known history of pterygium. Both cohorts were linked to the WA Cancer Registry and the WA Deaths Registry.

Results 23 625 people had pterygium treatment (64% male) in WA hospitals. The median age for pterygium diagnosis and/or treatment was 49 years (range 14–96). There were significantly more CM cases in the pterygium cohort compared with the control cohort (1083 vs 874; p<0.001). In a logistic regression analysis, there was a 24% increase in the odds of developing a CM in the pterygium cohort, compared with controls, after controlling for other predictors (OR 1.24, 95% CI 1.1 to 1.4). The incident rate ratio (IRR) of a malignant CM diagnosis was 20% greater in people who had treatment for a pterygium compared with controls (IRR 1.2, 95% CI 1.0 to 1.4).

Conclusion The presence of a pterygium indicates a significantly increased risk of developing a CM. Eye care providers who see patients with developing pterygia should advise these patients of this increased risk and recommend regular skin surveillance.

  • epidemiology
  • ocular surface

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  • Contributors Professor DAM was responsible for the original concept for this research. All authors contributed to the planning, analyses, reporting and final oversight of this manuscript. JMC affirms that the manuscript is an honest, accurate and transparent account of the study being reported and that no important aspects of the study have been omitted.

  • Funding This study was funded by private donations to the Lions Eye Institute. The sponsors had no role in the design or conduct of this research.

  • Competing interests None declared.

  • Patient consent This study was exempt from obtaining consent from individuals by the ethics committee. The study uses health service data on more than 45 000 individuals.

  • Ethics approval University of Western Australia and the Department of Health of Western Australia

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No data currently available due to confidentiality restrictions.

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