Sex differences in melanoma survival - A GEM study Journal Article


Authors: Murali, T.; Schwartz, M.; Reynolds, A. Z.; Luo, L.; Ridgeway, G.; Busam, K. J.; Cust, A. E.; Anton-Culver, H.; Gallagher, R. P.; Zanetti, R.; Rosso, S.; Sacchetto, L.; Begg, C. B.; Orlow, I.; Thomas, N. E.; Berwick, M.; for the GEM Study Team
Article Title: Sex differences in melanoma survival - A GEM study
Abstract: Sex differences in melanoma are prominent, with female having a significant survival advantage. However, it is unclear why we see this survival advantage. Here, we investigate the relationship between sex, clinicopathologic variables, and melanoma specific survival in 1753 single primary melanomas from patients in the GEM (Genes, Environment, and Melanoma) study. Using Cox proportional hazard models and formal mediation analysis, the effect of sex on survival is explained largely by differences in the clinicopathologic features of tumors at diagnosis. Specifically, we find evidence that 86.5% of the effect of sex on melanoma survival is mediated by differences in age at diagnosis, Breslow thickness, ulceration, mitoses, and site (hazard ratio [HR] = 1.85, P < .001). This analysis indicates that the female survival advantage in melanoma is not primarily due to a direct effect of sex (HR = 1.19, P = .42) but is largely a result of an indirect effect of sex mediated by clinicopathologic features.
Keywords: cutaneous melanoma; sun; stage; malignant-melanoma; inhibition; european organization; pooled analysis; exposure; american joint committee; vitamin-d; gender-differences
Journal Title: JNCI Cancer Spectrum
Volume: 9
Issue: 1
ISSN: 2515-5091
Publisher: Oxford University Press  
Date Published: 2025-02-01
Start Page: pkaf005
Language: English
ACCESSION: WOS:001418044600001
DOI: 10.1093/jncics/pkaf005
PROVIDER: wos
PMCID: PMC11812020
PUBMED: 39799507
Notes: MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PubMed and PDF -- Source: Wos
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MSK Authors
  1. Colin B Begg
    306 Begg
  2. Irene Orlow
    247 Orlow
  3. Klaus J Busam
    688 Busam