The association of cutaneous and iris nevi with uveal melanoma: a meta-analysis.

ABSTRACT

PURPOSE: To study the relationship between cutaneous and iris nevi with uveal melanoma. DESIGN: Meta-analysis. METHODS: Three researchers independently searched the literature using Medline from 1966 to August 2007 (with both Ovid and PubMed), EMBASE, MD Consult, and the Web of Science. All bibliographies were searched, and an attempt to contact all primary authors was made to find further unpublished studies. MAIN OUTCOME MEASURES: Risk factor data were extracted into 4 a priori groups (1) atypical cutaneous nevi, (2) common cutaneous nevi, (3) cutaneous freckles, and (4) iris nevi. RESULTS: Meta-analysis of 4 studies (850 cases) examining atypical cutaneous nevi yielded a summary odds ratio (OR) of 2.82 (95% confidence interval [CI], 1.10-7.26; P=0.032). Common cutaneous nevi were reported in 4 studies (825 cases), yielding a summary OR of 1.74 (CI, 1.27-2.39; P=0.001). Cutaneous freckles using 7 studies (2122 cases) found an OR of 1.22 (CI, 1.03-1.45; P=0.022). Iris nevi using 4 studies (825 cases) found an OR of 1.53 (CI, 1.03-2.27; P=0.036). There was no evidence of publication bias for the aforementioned risk factors, with the exception of atypical cutaneous nevi (P=0.03). CONCLUSIONS: This meta-analysis supports an association between uveal melanoma and atypical cutaneous nevi, common cutaneous nevi, cutaneous freckles, and iris nevi.