The relationship of marital status to survival from melanoma

Abstract

As an indirect test of the hypothesis that prior pregnancy has a favorable influence on prognosis in melanoma, the relation of marital status to survival among melanoma patients was examined in data gathered by the Connecticut Tumor Registry, 1935-1973. Compared to women who had never been married, ever-married women with the disease had a slightly increased survival rate, but the difference was not statistically significant. If a difference between parous and nulliparous women in survival from melanoma truly exists, it is probably a small one, and could be due to differences in characteristics other than childbearing.Cancer 42:296-298, 1978.URVIVAL FROM MELANOMA IS better among S women than men.6 Since several melanoma antigens appear to be similar to those present in fetal t i~s u e ,~ one possible reason for this improved survival is that sensitization to fetal antigens during pregnancy helps to inhibit progression of the disease. In a test of this hypothesis, Hersey et al. ' compared survival among women with melanoma who had borne children with survival among those who had not. A difference between the groups was first evident two years after diagnosis, and at five years 77% of parous women were alive compared to 68% of nulliparous women (p < .05).The existence of a parity-survival association in melanoma has potential implications for therapy-as well as for our understanding of how this cancer spreads-so that it will be important to receive independent confirmation of the latter finding. Unfortunately, the resources necessary to do an analysis of this sort are not commonly available. As the incidence of melanoma is low, and only a small minority of women who develop it have not had children, the number of nulliparous cases From the

Reproductive factors, oral contraceptives and risk of malignant melanoma: Western Canada Melanoma Study

“…However, an equal or greater number have found no difference, or a worse survival in women with prior pregnancies (Elwood & Coldman, 1978;Weiss & Flannery, 1978; Lee & Hill, 1970). While the relationship of pregnancy factors with melanoma is presently unclear, to our knowledge no studies to date have found reproductive events to be risk factors in the aetiology of melanoma, with the exception of Holly et al (1983).…”

Malignant melanoma: sex differences in survival after evidence of distant metastasis

“…Reports on the role of previouts pregnancies are conflicting (Hersey et al, 1977;Shaw et al, 1 978;Weiss & Flannery, 1978). The effect of previous gestation might, be immunological (immunization against tumour-associated foetal antigens?)…”

Natural history of cutaneous malignant melanoma

“…Exposure to fetal antigens during pregnancy has been proposed as a possible explanation for this difference. Another study [70] shows a numerical, but not statistically significant, increase in survival rates in married versus unmarried women with melanoma. The relationship of sex to prognosis in cutaneous melanoma is, at present, undetermined.…”