Association of Socioeconomic Status With Breslow Thickness and Disease-Free and Overall Survival in Stage I-II Primary Cutaneous Melanoma

Mandalà, Mario; Imberti, G.; Piazzalunga, Dario; Belfiglio, Maurizio; Lucisano, Giuseppe; Labianca, Roberto; Marchesi, L.; Merelli, Barbara; Robone, Silvana; Poletti, Paola; Milesi, Laura; Tondini, Carlo

doi:10.4065/mcp.2010.0671

Cited by 34 publications

(42 citation statements)

References 25 publications

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“…I ndividuals with higher education more often self-examined their skin for suspicious lesions before being diagnosed with melanoma, which confirms previous melanoma research findings [11] and further builds on a growing body of literature linking higher education with healthier life choices and less risky behaviours [12]. As education and socioeconomic status are interrelated, this result further corroborates previous research demonstrating that individuals with lower socioeconomic status are burdened with higher melanoma-related mortality [13]. The fact that this study did not find an association at pre-diagnosis between educational level and the use of a melanoma picture or the use of someone’s help during SSE suggests that even higher educated individuals may be lacking the more specific knowledge about how to conduct effective SSE.…”

Section: Discussionsupporting

confidence: 87%

Predictors of skin self-examination before and after a melanoma diagnosis: the role of medical advice and patient’s level of education

Körner¹,

Coroiu²,

Martins³

et al. 2013

Int Arch Med

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BackgroundCutaneous melanoma is the fastest growing tumor of the skin and the median life span of patients with advanced disease is less than a year. Melanoma-related mortality can be reduced through early detection via clinical skin exams and patient self-examination. Despite the potential to reducing the medical burden associated with clinical skin exams, systematic and regular skin self-examinations (SSE) are rarely performed. The current study examined psychosocial predictors of SSE and changes in SSE behavior from pre- to post-diagnosis in order to guide future melanoma prevention initiatives.FindingsA consecutive sample of 47 melanoma survivors was drawn from a tertiary care clinic. Most melanomas had been detected by patients, spouses and other laypersons. Higher education was related to more frequent SSE at pre-diagnosis, more thorough SSE at post-diagnosis, and more frequent reports of having been advised to perform SSE at post-diagnosis. SSE behaviors increased significantly from pre- to post-diagnosis.ConclusionsThese findings suggest that different patient subgroups display varied knowledge base, readiness for change, and receptiveness for medical advice. Thus, interventions seeking to enhance skin self-exam practice may be most effective when the individual’s psychosocial characteristics are taken into account.

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Section: Discussionsupporting

confidence: 87%

Predictors of skin self-examination before and after a melanoma diagnosis: the role of medical advice and patient’s level of education

Körner¹,

Coroiu²,

Martins³

et al. 2013

Int Arch Med

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“…National guidelines for CMM diagnosis, treatment and follow-up have been implemented to minimise variation in the primary management. Despite this, in the present study, patients with lower education had more advanced disease at diagnosis, corroborating previous studies (40,41,44,46,47,(59)(60)(61). This finding explains in part the lower CMM-specific survival among low-educated groups in the After adjusting for clinical stage at diagnosis and for other prognostic factors, patients with low education still had a13% higher risk of CMM death compared to patients with high education.…”

Section: Paper IIIsupporting

confidence: 90%

“…Our finding that low SES as measured by level of education is associated with a worse outcome is supported by previous studies of varying design (40)(41)(42)(43)(44)(46)(47)(48). In Sweden, the tax-funded national health care system aims to provide care on equal terms to all citizens.…”

Section: Paper IIIsupporting

confidence: 89%

“…A higher SES has been shown to increase the risk of CMM, whereas a worse outcome has been reported for patients with low SES (39)(40)(41)(42)(43)(44)(45)(46)(47)(48). Only a few population-based studies have explored CMM prognosis in relation to SES and many of these lack information on SES on the individual level (41,(44)(45)(46)(47).…”

Section: Level Of Education In Relation To Clinical Stage and Prognosmentioning

confidence: 99%

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Clinical-epidemiological studies on cutaneous malignant melanoma : A register approach

Lyth¹

2015

Linköping University Medical Dissertations

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“…The major variable associated with improved survival with melanoma was number of holidays to sunny places; it is possible that this variable is confounded with socioeconomic status, which has been found to be inversely associated with hazard of death from melanoma in three studies (13–15). …”

Section: Discussionmentioning

confidence: 99%

Sun Exposure and Melanoma Survival: A GEM Study

Berwick

Reiner

Paine

et al. 2014

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background We previously reported a significant association between higher ultraviolet radiation exposure before diagnosis and greater survival with melanoma in a population-based study in Connecticut. We sought to evaluate the hypothesis that sun exposure prior to diagnosis was associated with greater survival in a larger, international population-based study with more detailed exposure information. Methods We conducted a multi-center, international population-based study in four countries – Australia, Italy, Canada and the United States – with 3,578 cases of melanoma with an average of 7.4 years of follow-up. Measures of sun exposure included sunburn, intermittent exposure, hours of holiday sun exposure, hours of water-related outdoor activities, ambient UVB dose, histological solar elastosis and season of diagnosis. Results Results were not strongly supportive of the earlier hypothesis. Having had any sunburn in one year within 10 years of diagnosis was inversely associated with survival; solar elastosis – a measure of lifetime cumulative exposure – was not. Additionally, none of the intermittent exposure measures – water related activities and sunny holidays - were associated with melanoma-specific survival. Estimated ambient UVB dose was not associated with survival. Conclusion Although there was an apparent protective effect of sunburns within 10 years of diagnosis, there was only weak evidence in this large, international, population-based study of melanoma that sun exposure prior to diagnosis is associated with greater melanoma-specific survival. Impact This study adds to the evidence that sun exposure prior to melanoma diagnosis has little effect on survival with melanoma.

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Association of Socioeconomic Status With Breslow Thickness and Disease-Free and Overall Survival in Stage I-II Primary Cutaneous Melanoma

Cited by 34 publications

References 25 publications

Predictors of skin self-examination before and after a melanoma diagnosis: the role of medical advice and patient’s level of education

Predictors of skin self-examination before and after a melanoma diagnosis: the role of medical advice and patient’s level of education

Clinical-epidemiological studies on cutaneous malignant melanoma : A register approach

Sun Exposure and Melanoma Survival: A GEM Study

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