Understanding the impact of sex and stage differences on melanoma cancer patient survival: a SEER-based study

• Published in: British journal of cancer Vol. 124; no. 3; pp. 671 - 677
• Main Authors: Smith, Aiden J., Lambert, Paul C., Rutherford, Mark J.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 02.02.2021; Nature Publishing Group
• Subjects: 631/67; 631/67/1813/1634; 692/4028/67/2324; Age Factors; Biomedical and Life Sciences; Biomedicine; Cancer Research; Diagnosis; Drug Resistance; Epidemiology; Female; Females; Gender differences; Humans; Life Expectancy; Life span; Male; Males; Medical diagnosis; Medical prognosis; Melanoma; Melanoma - mortality; Melanoma - pathology; Middle Aged; Molecular Medicine; Oncology; Prognosis; SEER Program; Sex; Sex differences; Sex Factors; Skin cancer; Skin Neoplasms - mortality; Skin Neoplasms - pathology; Survival
• ISSN: 0007-0920; 1532-1827; 1532-1827
• DOI: 10.1038/s41416-020-01144-5

Background This paper investigates the difference in survival of melanoma patients across stage and sex by utilising net survival measures. Metrics are presented at both the individual and population level. Methods Flexible parametric models were fitted to estimate life-expectancy metrics to be applied to a group of 104,938 subjects with a melanoma skin cancer diagnosis from 2000 to 2017. Period analysis was used for better predictions for newly diagnosed patients, and missing-stage information was imputed for 9918 patients. Female relative survival was assigned to male subjects to demonstrate the survival discrepancies experienced between sexes. Results At the age of 60, males diagnosed at the regional stage lose an average of 4.99 years of life compared to the general population, and females lose 4.79 years, demonstrating the sex variation in expected mortality. In 2017, males contributed 3545 more life years lost than females, and a potential 1931 life years could be preserved if sex differences in survival were eliminated. Conclusions This study demonstrates the survival differences across population subgroups as a result of a melanoma cancer diagnosis. Females experience better prognosis across age and stage at diagnosis; however, further investigation is necessary to better understand the mechanisms behind this difference.