Gender-Dependent Specificities in Cutaneous Melanoma Predisposition, Risk Factors, Somatic Mutations, Prognostic and Predictive Factors: A Systematic Review

Abstract

Background and aim: Over the last decades, the incidence of melanoma has been steadily growing, with 4.2% of the population worldwide affected by cutaneous melanoma (CM) in 2020 and with a higher incidence and mortality in men than in women. We investigated both the risk factors for CM development and the prognostic and predictive factors for survival, stratifying for both sex and gender. Methods: We conducted a systematic review of studies indexed in PUB-MED, EMBASE, and Scopus until 4 February 2021. We included reviews, meta-analyses, and pooled analyses investigating differences between women and men in CM risk factors and in prognostic and predictive factors for CM survival. Data synthesis: Twenty-four studies were included, and relevant data extracted. Of these, 13 studies concerned potential risk factors, six concerned predictive factors, and five addressed prognostic factors of melanoma. Discussion: The systematic review revealed no significant differences in genetic predisposition to CM between males and females, while there appear to be several gender disparities regarding CM risk factors, partly attributable to different lifestyles and behavioral habits between men and women. There is currently no clear evidence of whether the mutational landscapes of CM differ by sex/gender. Prognosis is justified by a complex combination of phenotypes and immune functions, while reported differences between genders in predicting the effectiveness of new treatments are inconsistent. Overall, the results emerging from the literature reveal the importance of considering the sex/gender variable in all studies and pave the way for including it towards precision medicine. Conclusion: Men and women differ genetically, biologically, and by social construct. Our systematic review shows that, although fundamental, the variable sex/gender is not among the ones collected and analyzed.

Prognostic model for predicting overall and cancer-specific survival among patients with superficial spreading melanoma: A SEER based study

“…[ 16 ] Our study was based on the median age of previous studies of melanoma, with an age cutoff of 60 years, and demonstrated that ≥ 60 years was a negative predictor of OS and CSS prognosis in patients with SSM, and the results were consistent with the study of Michael et al [ 17 ] Men have a higher incidence of melanoma than women, and women have a higher relative survival rate than men. [ 18 , 19 ] This study also demonstrated lower OS and CSS rates in male patients with SSM, which is consistent with previous studies. Compared with patients of other races, the incidence of SSM in whites was significantly higher than that in other people of color, but the data in this study showed that the number of cases in people of color was very small, and race was not an independent factor in our study.…”

Melanoma Molecular Subtypes and Development of Prognostic and Immunotherapy-Related Genetic Characteristics by Ferroptosis Gene Analysis

“…Superficial diffusion, nodular, and malignant freckles are the three main histological types of SKCM [ 1 ]. By 2020, 4.2% of the global population suffered from SKCM [ 2 ]. SKCM accounts for about 5% of all skin cancers but more than 2/3 of all skin cancer-related mortality.…”

Review: The Key Factors to Melanomagenesis

“…The exact cause of melanoma is not yet understood, but there are certain factors that may initiate and promote its development: ultraviolet (UV) radiation, indoor tanning [ 8 , 9 , 10 ], prolonged sun exposure/sunburn [ 11 ], burn scars [ 12 , 13 , 14 ], pesticides, genetic factors/heredity, geographical location, skin phototype, immunosuppression, hormonal changes, a high number of nevi, neuroendocrine factors, stress, depression [ 15 ], trauma, low socioeconomic status, non-melanoma skin cancers, autoimmune diseases, viral infections, biological/cytologic factors, smoking/alcohol, medicines, gender (melanoma has a higher incidence in men [ 16 , 17 , 18 , 19 , 20 ]), etc. [ 1 , 21 , 22 , 23 ].…”