Men with melanoma have worse survival rates than women, possibly related to delayed diagnosis, study results published in the Journal of the European Academy of Dermatology and Venereology suggest.
The study was an analysis of data obtained from the Dutch Nationwide Network and Registry of Histopathology and Cytopathology (PALGA). Only data of patients with primary, cutaneous stage 1, 2, and 3 melanoma without clinically detectable nodal disease who were treated in the Netherlands between 2000 and 2014 were included. The Netherlands Cancer Registry was used to obtain follow-up data. Researchers calculated multivariable relative excess risks (RER) to compare relative survival rates in men (n=23,879) and women (n=30,766).
A significantly greater percentage of men with melanoma were included in the PALGA in 2014 vs 2000 (47.3% vs 41.7%, respectively; P <.001). In addition, in 2000, 51.5% of the deceased cohort was comprised of men compared with 60.1% in 2014 (P <.001). At the time of diagnosis, men had thicker melanomas compared with women (median Breslow thickness, 1.00 mm [interquartile range (IQR), 0.60-2.00] vs 0.82 mm [IQR, 0.50-1.50], respectively; P <.001).
Men were also older at diagnosis (56 to 75 years, 45.2% vs 33.9%), more often had ulcerated melanomas (15.9% vs 11.3%), and more often had melanomas on the trunk (55.4% vs 31.1%) or head and neck (15.5% vs 10.3%) compared with women (P <.001 for all). Women had significant improvements in survival over time compared with men who had worsening survival (P <.001). In the adjusted multivariable analysis, men had a higher risk of dying compared with women (relative excess risk, 1.37; 95% CI, 1.31-1.45).
A limitation of the analysis includes its retrospective nature.
“To better inform patient on their prognosis,” the investigators wrote, “gender should be taken into account and the development of a prediction model separate for men and women for survival would be useful.”
El Sharouni MA, Witkamp AJ, Sigurdsson V, et al. Sex matters: men with melanoma have a worse prognosis than women. J Eur Acad Dermatol Venereol. 2019;33(11):2062-2067.