Unmarried patients face shorter survival, later stage at diagnosis of cutaneous melanoma

More advanced stages of cutaneous melanoma are usually diagnosed among unmarried patients, especially men and those younger than 68 years of age, even in visible sites such as the face, according to a US study. In addition, these patients have worse survival independent of stage.

To determine the significance of marital status in melanoma outcomes across anatomic sites, the investigators conducted a retrospective cohort study of 73,558 patients from the Surveillance, Epidemiology and End Results (SEER) programme as well as 2,992 patients at Johns Hopkins University. They stratified participants by age, sex, marital status, and anatomic site. Prevalence of advanced melanoma (stage III or IV) and survival were the study endpoints.

Single patients in the SEER cohort were more likely than married ones to present in stages III or IV among both men (prevalence ratio [PR], 1.45, 95 percent confidence interval [CI], 1.37–1.53) and women (PR, 1.28, 95 percent CI, 1.18–1.39). Such trend persisted across all anatomic sites and in all age groups, particularly in those aged 18–68 years.

Moreover, unmarried patients had shorter overall and cancer-specific survival times. Likewise, single patients at Johns Hopkins had increased prevalence of advanced melanoma (PR, 1.54, 95 percent CI, 1.21–1.94) and experienced shorter overall survival (hazard ratio, 1.51, 95 percent CI, 1.15–1.99).

The study was limited by its retrospective design. In addition, the anatomic sites were not very specific.

“Addressing risk factors of delayed melanoma detection minimizes disparities in outcome,” the investigators said.