Marital Status and Survival in Patients Diagnosed with Melanoma

Abstract

Introduction. Previous research suggests the presence of a spouse may considerably affect melanoma detection rates through more frequent examinations, better access to healthcare, and improved social support. Yet, the role of marital status on melanoma survival is currently unknown. The aim of this study is to assess whether marital status is associated with survival following melanoma diagnosis. Methods. We performed secondary analysis of data from all participants of the Florida Cancer Data System (FCDS) and included adult melanoma patients diagnosed between 2001 and 2009 with follow-up information available until 2015. Marital status was categorized as single, married, divorced, or widowed. The primary outcome was survival interval after melanoma diagnosis, which was assessed according to the time from the date of diagnosis to the time of death or last contact. Cox proportional hazard models were used to assess the independent association between marital status and survival. Results. We assessed data from 36,578 melanoma patients. Married patients were significantly more likely to survive than single patients (Hazard ratio (HR) = 0.65; 99% Confidence Interval (CI): 0.57–0.74; P<0.001) after adjusting for age, sex, race, ethnicity, geographic location, insurance status, tobacco use, primary site, stage, and histology. There was no evidence of effect modification by gender (P=0.189). Conclusions. Married patients, including both men and women, had a 35% reduction in the risk of death after melanoma diagnosis compared with single patients, and mechanisms independent of earlier detection, such as social support, may play a role in survival in patients with melanoma.

Competing‐risks model for predicting the prognosis of patients with regressive melanoma based on the SEER database

“…However, our result is not consistent with the results of other recent melanoma-related studies [40,41]. Scholars commonly agree that a stable marriage can enhance the likelihood of survival in cancer patients [39][40][41]. Nonetheless, it is worth highlighting that based on official 2010 data from the United States, approximately 90 million unmarried individuals aged 15 and above cohabit with a partner, in contrast to around 30 million who reside alone [39].…”

“…It is worth noting that research examining the influence of marital status on cancer patient survival has produced diverse findings, as highlighted in the article by Aizer et al [39]. However, our result is not consistent with the results of other recent melanoma‐related studies [40, 41]. Scholars commonly agree that a stable marriage can enhance the likelihood of survival in cancer patients [39–41].…”

Marital status and survival in cancer patients: A systematic review and meta‐analysis

“…Twenty‐two studies compared cancer specific survival in unmarried and married cancer patients, of which all but two 22 , 38 reported that married patients had a higher cancer‐specific survival rate than unmarried patients. The association was found in five studies on patients with breast cancer, 21 , 32 , 33 , 39 , 40 two studies on patients with prostate cancer 26 , 27 ; and one study each in patients with testicular, 30 head and neck, 41 gastric, 42 kidney, 34 colon, 43 oral cavity, 44 non‐metastatic urothelial bladder cancer, 45 non‐small cell lung cancer, 46 melanoma, 47 medullary thyroid, 37 colorectal 48 and liver cancer, 49 and in one study with various cancer types. 25 …”

Demographics, Clinical Characteristics and Survival Outcomes of Primary Urinary Tract Malignant Melanoma Patients: A Population-Based Analysis

“…In consequence, as in other primaries, more advanced age, as well as unmarried status should be considered as a potential risk factor for less favorable survival [ 36 , 37 , 38 , 39 ]. Specific social and clinical measures addressing or focusing on older patients and unmarried patients may potentially improve their survival [ 40 , 41 , 42 , 43 ]. However, due to the limited number of observations, these results cannot prompt final recommendation.…”