Unmarried patients may need more frequent dermatology visits
Married patients with melanoma are more likely to get a timely diagnosis and treatment of their disease compared with those who are unmarried, divorced or widowed, shows the latest research published in Jama Dermatology.
The researchers, based out of the Hospital of the University of Pennsylvania, noted that while marital status has been shown to improve outcomes in breast, colon and renal cancers, for melanoma it is also linked to a risk for regional and/or distant metastases at diagnosis. Unmarried patients present with more advanced stages of disease.
Using a large cancer registry, the researchers identified 52,063 patients (with an average age of 64) with nonmetastic melanoma who had recorded marital and sentinel lymph node status from 2010 to 2014. Of the more than 16,000 married patients, 46% presented with early-stage melanoma compared with 43% of those divorced or never-married and 32% of widowed patients. Widowed patients were also more likely to present at a later stage of the disease than those who were married.
Married patients were also more likely to undergo sentinel lymph node biopsy for appropriate tumours.
The researchers say these findings support increased emphasis on training spouses to exam their partner’s skin for irregularities and perhaps more frequent screening for unmarried patients.
The study’s senior author, Dr. Giorgos C. Karakousis, an associate professor of surgery at the University of Pennsylvania, said the real message here is two-fold: Having a long-term partner plays a positive role in getting patients to seek medical help sooner, and to follow through with recommended treatment. “That may speak to the fact that having your spouse with you allows you to make more informed decisions, especially when you’ve just been diagnosed with cancer and are not thinking completely straight,” he said.
“The implications of these results could be that dermatologists consider altering the frequency schedule for their unmarried patients—and encourage them to bring a friend during medical visits,” added Dr. Karakousis.
The research group will now explore their own institutional records in more depth to extract more information around marital status and melanoma diagnosis/treatment. One of the questions will be to determine whether people in long-standing relationships achieve similar outcomes to those who are married.
“We’re also considering the potential of a pilot study with the dermatology group here to see whether changing frequency of visits based on marital status will impact outcomes,” he said.
Article by CANADIANHEALTHCARENETWORK.CA