Married patients more likely to find melanoma earlier
Married patients with melanoma appeared more likely to present with early-stage disease than divorced, widowed or never-married patients, according to findings published in JAMA Dermatology.
Researchers noted that socioeconomic factors have been recognized in as influencing cancer outcomes.
“In particular, marital status has been shown to be associated with improved outcomes in breast, colon and renal cancer,” Cimarron E. Sharon, BS, first year resident in the department of surgery at Hospital of the University of Pennsylvania, and colleagues wrote. “For melanoma specifically, marital status has also been found to be associated with the risk [for] regional and/or distant metastases at diagnosis, with unmarried patients presenting with more advanced disease.
“However, whether any association exists between marital status and tumor stage at presentation among patients with clinically localized disease has not been determined,” they added.
The researchers used the SEER database to identify 52,063 patients (58.8% men; median age, 64 years) who presented with nonmetastatic melanoma and who had recorded marital and sentinel lymph node status from 2010 to 2014. Clinical tumor stage at presentation and the performance of sentinel lymph node biopsy on any lesions with a Breslow thickness of more than 1mm served as the main outcomes.
Of a total 16,603 married patients, 45.7% presented with stage T1a disease compared with 43% of patients who were never married, 39% of divorced patients and 32.2% of widowed patients (P < .001).
More widowed patients presented with T4b disease (9.4%) than married patients (3.3%).
After researchers adjusted for socioeconomic and patient factors, a significant association remained between marital status and higher tumor stage at presentation among never-married patients (OR = 1.32; 95% CI, 1.26-1.39), divorced patients (OR = 1.38; 95% CI, 1.3-1.47) and widowed patients (OR = 1.7; 95% CI, 1.6-1.81).
Married patients also appeared more likely to undergo sentinel lymph node biopsy for lesions with a Breslow thickness of more than 1 mm — per standard recommendations — than never-married (OR = 0.59; 95% CI, 0.53-0.65) divorced (OR = 0.87; 95% CI, 0.76-0.99) and widowed patients (OR = 0.69; 95% CI, 0.62-0.76), independent of tumor stage or other patient factors.
“These findings support increased consideration of spousal training for partner skin examination and perhaps more frequent screening for unmarried patients, practical interventions with potentially significant clinical implications.” – by Andy Polhamus
Disclosures: The authors report no relevant financial disclosures.