Uveal Melanoma FAQ

Auburn University offers the below Q&A that addresses the latest involving the Alabama Department of Public Health’s determination that no cancer cluster exists involving reported cases of uveal melanoma in the Auburn area.  The below information addresses what Auburn has done in addressing this issue and next steps moving forward.

How did the Alabama Department of Public Health determine that the area’s reported uveal melanoma cases do not constitute a cancer cluster?
The Alabama Department of Public Health performed a cluster investigation using the Center for Disease Control and Prevention guidelines as specified in the September 27, 2013, edition of the Morbidity and Mortality Weekly Report.  ADPH first did an analysis utilizing Alabama Statewide Cancer Registry (ASCR) data comparing the residents of Lee County to the rest of Alabama. Utilizing Surveillance, Epidemiology, and End Results Program (SEER) data, ADPH also compared Lee County to national rates. This analysis found no significant elevation of uveal melanoma (UM) cases among the residents of Lee County when compared to either Alabama or national rates. Therefore, there is no cluster of uveal melanoma among Lee County residents.

Cancer registries have no mechanism to identify the college that a cancer patient attended. As such, ADPH was reliant on a list that was provided by a cancer survivor to identify which UM patients attended Auburn. ADPH used ASCR records to verify that the patients on this list matched the case definition. For patients that were diagnosed while living out of state, ADPH contacted the registry of that respective state for verification. Once patients were verified as cases, a list was sent to Auburn in order to confirm attendance or employment at the university.  Auburn then provided a population file beginning with 1980 for both students and employees. ADPH was then able to calculate the number of expected cases among Auburn employees and students based on ASCR data for Alabama. ADPH also performed an analysis comparing the students and employees to national rates obtained from SEER. The number of cases among Auburn students and employees observed was found to be within normal expected ranges using ASCR data and SEER data as the comparison group. Therefore, the UM cases among Auburn students and employees were deemed not to be a cluster.

With the state’s determination of there being no cluster of uveal melanoma cases in the area, what are the next steps in the process?
Uveal melanoma is a rare form of cancer for which a cause has yet to be found. Most of the patients in this cohort have or are a part of surveillance and research studies and one would expect those to continue. Most of them are also being cared for by some of the world’s best experts in this type of cancer. 
  
What does Auburn plan to do going forward to address past, current and future cases of uveal melanoma?
We will continue working collaboratively with the Alabama Department of Public Health Cancer Registry Division to collect and analyze data as provided to them going into the future for their statistical analysis. Since we were made aware of our alumni or former employees who were diagnosed with this rare form of cancer, we have regularly worked with the Alabama Department of Public Health and other expert scientific authorities to share information in the hope of gathering useful and verifiable data that can benefit the search for a cause and, we hope, a cure.

What has Auburn’s involvement been in helping address the area’s reported cases of uveal melanoma?
Since we first became aware that several members of the Auburn family were diagnosed with ocular melanoma, we have had collaborative communications with experts on melanoma from around the nation, and we have worked closely with state public health officials. These communications are ongoing as the experts assist in determining what next steps should be taken in the best interests of the patients who are battling this cancer. We have also provided informational resources and updates to the campus community and beyond so those concerned have the latest information that is available. Auburn University supports awareness of uveal melanoma and the need for early detection, and we are hopeful that research and awareness will advance the prevention and treatment of this cancer.

Beyond the Alabama Department of Public Health and Auburn, what researchers or other medical professionals have been involved in analyzing the area’s reported cases of uveal melanoma?
Dr. John Mason of the University of Alabama at Birmingham School of Medicine, Dr. Marlana Orloff of Thomas Jefferson University, Dr. William Harbaugh of the Bascom Palmer Eye Institute at Miami University and Dr. Mike Brennan, a retired ophthalmologist from Burlington, N.C., have been involved in the investigative sharing of information regarding a cohort of patients.

At this point, what is known as to whether or not there are any connections/themes to be made involving the area’s uveal melanoma cases? The Alabama Department of Public Health has determined there is no cluster of uveal melanoma cases as it relates to Auburn University, whether through attendance or employment. Regardless, Auburn will continue to partner in research efforts toward identifying the cause or causes of uveal melanoma and possible treatment or cure.

Will Auburn University consider any future research opportunities focused on this rare form of eye cancer? Yes. Although the State has determined that no cluster exists in Auburn, we are committed to partnering with the scientific and medical community in research. Auburn will partner with leading ocular melanoma experts to facilitate genetic and tissue testing based on the experts’ recommendation that such research is the best method toward identifying the cause or causes of uveal melanoma and possible treatment or cure. More details will follow as to any future testing as future steps are determined.

Auburn had previously announced it would engage geospatial research experts to gather and analyze data to explore potential links to ocular melanoma in this area. Will that effort continue?
Although no cancer cluster was definitively found by the Alabama Department of Public Health, after a meeting of the scientific experts and other interested participants in February and April 2019, it was decided to do both a geospatial analysis and genetic/tissue testing.

For more information about uveal melanoma please visit the following websites:
National Cancer Institute Intraocular Melanoma for Patients
National Cancer Institute Intraocular Melanoma for Health Professionals
National Institutes of Health Guide on Ocular Melanoma
American Cancer Society Guide on Eye Cancer
The Ocular Melanoma Foundation