Marriage may be good for catching melanoma early

[May 12, 2018] By Lisa Rapaport

(Reuters Health) - Married people may be more likely to spot a deadly skin cancer sooner than their counterparts who aren't part of a couple, a U.S. study of melanoma patients suggests.

For the study, researchers examined data on 52,063 adults diagnosed with early-stage melanoma from 2010 to 2014. The study included 36,307 married patients, 7,570 never-married people, 3,650 individuals who were divorced and 4,536 who were widowed.

Compared to married patients, widows were 70 percent more likely to have early-stage melanoma diagnosed when it was thicker and harder to treat, while divorced people were 38 percent more likely to get diagnosed later and never-married individuals had 32 percent higher odds, the study team reports in JAMA Dermatology.

"We suspect that part of the reason that married patients present with earlier-stage melanoma is from having another pair of eyes on their skin that allows for identification of suspicious lesions," said lead author Cimarron Sharon of the Hospital of the University of Pennsylvania in Philadelphia.

"People in long-term relationships see their partner's skin frequently over time, and are able to notice any new or changing lesions, especially in difficult to see areas, such as the back," Sharon said by email.

Melanoma diagnoses and deaths in the U.S. have been rising steadily in recent years despite widespread prevention efforts aimed at encouraging people to limit sun exposure and use sunscreen and protective clothing when they're outdoors.

Even with the majority of melanoma cases that are caught early, the thickness of tumors can influence how easy they are to treat and patients' survival odds.

In the current study, researchers wanted to see if marital status might influence how often people got diagnosed with early-stage melanoma at what's known as stage T1a, when tumors are no more than 1 millimeter thick and haven't reached the innermost layers of the skin.

Overall, 46 percent of married patients were diagnosed at stage T1a, compared with 43 percent of never-married people, 39 percent of divorced individuals and 32 percent of widows.

Married people were also more likely to get what's known as sentinel node biopsies to confirm whether tumors have spread to other parts of the body. This suggests that spouses not only catch the skin problems, but also push their partners to follow up with any recommended tests or treatments, Sharon said.

The study wasn't a controlled experiment designed to prove whether marriage actually helps people catch melanoma sooner or live longer with this diagnosis. One drawback of the study is that researchers lacked data on whether non-married people might be living with a partner or in a long-term relationship.

Even so, the results make sense and offer fresh evidence of the importance of having a another set of eyes on the lookout for changes in the skin, said Dr. Jeffrey Farma, surgical director of the melanoma program at Fox Chase Cancer Center in Philadelphia.

"Intuitively one would surmise that a partner would be more likely to identify or facilitate evaluation of a concerning skin lesion and this excellent paper has scientifically demonstrated this," Farma, who wasn't involved in the study, said by email.

"It is important for clinicians to understand these social implications when evaluating patients and considering treatment choices in these different groups of patients based on marital status," Farma added. "There is a higher chance that a partner could identify suspicious lesions in difficult-to-visualize areas."

Beyond just providing another set of eyes to be on the lookout for anything suspicious on the skin, a spouse might also help encourage people to seek medical help sooner and follow any recommendations from the doctor, said Dr. Saira George of the MD Anderson Cancer Center in Houston.

"Encouraging married people to partner up to examine their skin regularly could help magnify that benefit," George, who wasn't involved in the study, said by email. "For those who are unmarried, it may be worthwhile to emphasize the importance of skin self-examinations and regular clinical screenings or suggest they pair up with a friend or family member for skin checks and support in getting evaluation and treatment."

SOURCE: https://bit.ly/2Khb2wl JAMA Dermatology, online April 18, 2018.

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