Marital status and stage at diagnosis of cutaneous melanoma

Abstract

We evaluated the effect of marital status on risk of late-stage cutaneous melanoma diagnosis. Information about melanoma patients was obtained from Surveillance Epidemiology and End Results (SEER), 1973-2006. A multivariable logistic regression model was used to estimate relative risks of late-stage disease at diagnosis. After exclusion criteria, 192,014 adult melanoma patients remained for analyses. After adjustment for age, race, year of diagnosis, tumor histology, anatomic site, socioeconomic status, and SEER site, the relationship between estimated risk of late-stage melanoma diagnosis and marital status was dependent on sex (P < .0001 for interaction). Although unmarried patients had a higher risk of being diagnosed at a late stage among men and women, the magnitude of the effect varied by sex. Moreover, among married, single, and divorced or separated patients, men had more than a 50% increase in risk of late-stage diagnosis when compared with women. Widowed men and widowed women, however, were not statistically different in their stage at diagnosis. Results from this study are important and may be used by clinicians and public health practitioners interested in increasing the proportion of melanoma patients diagnosed at an early stage through screening, perhaps by specifically targeting unmarried individuals in addition to having broad-based skin cancer prevention programs.