There are differences in prognosis in cutaneous malignant melanoma depending on cohabitation status and gender, according to a new study published in the scientific periodical Journal of Clinical Oncology. Single men of all ages are more likely to die of their disease.
Cutaneous malignant melanoma is the most aggressive form of skin cancer. The disease is one of the fastest growing cancers among Caucasian (white) populations and is an escalating health problem even among young individuals. Swedish researchers from Karolinska Institutet and Linköping University have now, for the first time, made a detailed study of the link between the prognosis of cutaneous malignant melanoma and whether the patient lives alone or with a partner, by using the unique data from the Swedish Melanoma Register.
The current study is based on all cutaneous malignant melanomas diagnosed in Sweden between 1990 and 2007. The researchers examined the risk of dying from melanoma among more than 27,000 melanoma patients in relation to their cohabitation status at the time of diagnosis. The analysis adjusted for factors already known to affect the prognosis, such as the characteristics of the tumour, gender, educational level, and body site of the tumour was.
Melanoma of the skin can be cured if the tumour is surgically removed before the cancer cells have spread to other parts of the body. For thin cutaneous malignant melanoma that is detected early, long-term survival is over 90 per cent. However, for patients with advanced disease at the time of diagnosis, the prognosis is much worse. Early detection is essential for a good prognosis
"We were able to show that living alone among men is significantly associated with a reduced melanoma-specific survival, partially attributed to a more advanced stage at diagnosis. Our study shows that this applies to men of all ages, regardless of their level of education and place of residence," says first study author Hanna Eriksson, PhD at the Department of Oncology-Pathology, Karolinska Institutet, also working as an MD at the Karolinska University Hospital.
The researchers also found that older women living alone have a more advanced disease at diagnosis, but for single living women as a group there was no effect on the melanoma-specific prognosis.
"This points to a need for targeted interventions for earlier detection of cutaneous malignant melanoma in men and older individuals since this is critical for surviving the disease. By way of example, procedures are needed for skin examinations of these patients in connection with other doctor visits or check-ups," says Hanna Eriksson.
According to the researchers, one possible explanation, particularly for the men and older women diagnosed with melanoma in later stages, are differences in taking on board information about the disease. But it could also relate to insufficient access to skin examinations.
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"Later stage at diagnosis and worse survival in cutaneous malignant melanoma among men living alone: a nationwide population-based study from Sweden." Hanna Eriksson, Johan Lyth, Eva Månsson-Brahme, Margareta Frohm-Nilsson, Christian Ingvar, Christer Lindholm, Peter Naredi, Ulrika Stierner, John Carstensen and Johan Hansson. Journal of Clinical Oncology, online 31 March 2014, DOI: 10.1200/JCO.2013.52.7564