The influence of marital status on stage at diagnosis and survival of older persons with melanoma
The influence of marital status on stage at diagnosis and survival of older persons with melanoma
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DOI：
10.1093/gerona/62.8.892
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发表时间：
2007-08-01
影响因子：
5.1
通讯作者：
Goodwin, James S.
中科院分区：
文献类型：
--
作者：
Ortiz, Carlos A. Reyes;Freeman, Jean L.;Goodwin, James S.
背景。在过去的30年里，美国黑色素瘤的发病率和死亡率持续上升，尤其是在老年白人男性中。人们对老年人的婚姻状况和黑色素瘤预后之间的关系知之甚少。本研究的目的是确定婚姻状况与老年皮肤黑色素瘤的诊断阶段和生存之间的关系。数据来自监测、流行病学和最终结果（SEER）登记-医疗保险相关数据库（1991-1999）。样本包括14630名65岁及以上的男性和女性。结果是黑色素瘤诊断时的阶段和黑色素瘤的特异性生存。主要的自变量是婚姻状况，分为四类：已婚、单身、分居或离婚、丧偶。其他协变量包括社会人口统计学、诊断阶段、肿瘤特征（身体部位和组织学）和合并症指数。采用Logistic回归和生存分析技术。多因素分析显示，与已婚人士相比，丧偶人士更容易被诊断为晚期（局部或远处）黑色素瘤，而不是早期（原位或局部）黑色素瘤（优势比= 1.31,95%可信区间[CI]， 1.13-1.52）。此外，在控制了其他变量（社会人口统计学、诊断阶段、肿瘤特征和合并症）后，丧偶者死于黑色素瘤的风险增加（风险比= 1.23,95% CI, 1.06-1.44）。年长的丧偶人士比年长的已婚人士更有可能在晚期被诊断出并死于黑色素瘤。
Background. Melanoma incidence and mortality had a sustained increase in the last 3 decades in the United States, especially among white older men. Little is known about the relationship between marital status and melanoma outcomes in older people. The objective of this study was to determine the association between marital status and stage at diagnosis and survival of older persons with cutaneous melanoma.Methods. Data are from the Surveillance, Epidemiology and End Results (SEER) registries-Medicare-linked database (1991-1999). The sample consisted of 14,630 men and women 65 years old and older. The outcomes were melanoma stage at diagnosis and melanoma specific survival. The main independent variable, marital status, was used in four categories: married, single, separated or divorced, and widowed. Other covariates include sociodemographics, stage at diagnosis, tumor characteristics (body site and histology), and comorbidity index. Logistic regression and survival analyses techniques were used.Results. Multivariate analyses showed that, compared with married persons, widowed persons were more likely to be diagnosed with late-stage (regional or distant) versus early-stage (in situ or localized) melanoma (odds ratio = 1.31, 95% confidence interval [CI], 1.13-1.52). In addition, after controlling for A other variables (sociodemographics, stage at diagnosis, tumor characteristics, and comorbidity), widowed persons were at increased risk of death from melanoma (hazard ratio = 1.23, 95% CI, 1.06-1.44).Conclusion. Older widowed persons were more likely to be diagnosed at late stage and to die from melanoma than were older married persons.