Association of Socioeconomic Status With Breslow Thickness and Disease-Free and Overall Survival in Stage I-II Primary Cutaneous Melanoma
Open accessAbstract
Objective To investigate the influence of socioeconomic status (SES) on Breslow thickness, disease-free survival, and overall survival in patients with stage I-II primary cutaneous melanoma (PCM).Patients and methods The study consists of all consecutive patients who were diagnosed as having PCM and were treated and followed up at our hospital between November 1, 1998, and July 31, 2009. Pathologic and sociodemographic characteristics of the patients were obtained. We categorized SES into 3 levels: low (manual employees and skilled/unskilled workers, including farmers, with primary education level), middle (nonmanual employees and clerks with middle education level), and high (professionals, executives, administrators, and entrepreneurs with tertiary education).Results A total of 1443 consecutive patients were evaluated. In a multivariate logistic regression analysis, sex (female vs male: odds ratio [OR], 1.37; 95% confidence interval [CI], 1.08-1.75), SES (high vs middle: OR, 1.27; 95% CI, 0.96-1.69; high vs low: OR, 1.73; 95% CI, 1.26-2.38), age (<60 vs ≥60 years: OR, 1.35; 95% CI, 1.03-1.78), and family context (single vs living with relatives: OR, 1.37; 95% CI, 0.97-1.94) were the strongest correlates of Breslow thickness. Compared with high SES, the risk of melanoma-related death, adjusted for age and sex, was 7 times higher (hazard ratio, 7.44; 95% CI, 3.27-16.93) and almost 2 times higher (hazard ratio, 1.88; 95% CI, 1.04-3.39) in patients with low SES living alone or living with relatives, respectively.Conclusion In patients with PCM, low SES is associated with thicker melanoma and a poorer clinical outcome.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Numerous factors associated with a delayed diagnosis of melanoma are patient-related.
“Numerous factors associated with a delayed diagnosis are patient-related [4-12].”
From Use of Smartphones for Early Detection of Melanoma: Systematic Review (2018) · cites this paper as [11]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Regression Models and Life-Tables
Cox, D. R. (1972) · Journal of the Royal Statistical Society Series B: Statistical Methodology · doi:10.1111/j.2517-6161.1972.tb00899.x · Cited by 39,793 · see citing works
Regression Models and Life-Tables
Cox, D. R. (1992) · Springer Series in Statistics · doi:10.1007/978-1-4612-4380-9_37 · Cited by 26,297 · see citing works
Jemal, A., Siegel, R. L., Ward, E. M., Murray, T., Xu, J., Smigal, C., & Thun, M. J. (2006) · CA A Cancer Journal for Clinicians · doi:10.3322/canjclin.56.2.106 · Cited by 5,309 · see citing works
Balch, C. M., Soong, S., Gershenwald, J. E., Thompson, J. F., Reintgen, D. S., Cascinelli, N., Urist, M. M., McMasters, K. M., Ross, M. I., Kirkwood, J. M., et al. (2001) · Journal of Clinical Oncology · doi:10.1200/jco.2001.19.16.3622 · Cited by 2,385 · see citing works
Lantz, P. M., House, J. S., Lepkowski, J. M., Williams, D. R., Mero, R. P., & Chen, J. (1998) · JAMA · doi:10.1001/jama.279.21.1703 · Cited by 1,514 · see citing works
Differences in Breast Cancer Stage, Treatment, and Survival by Race and Ethnicity
Li, C. I., Malone, K. E., & Daling, J. R. (2003) · Archives of Internal Medicine · doi:10.1001/archinte.163.1.49 · Cited by 665 · see citing works
Halpern, M. T., Ward, E., Pavluck, A., Schrag, N. M., Bian, J., & Chen, A. Y. (2008) · The Lancet Oncology · doi:10.1016/s1470-2045(08)70032-9 · Cited by 567 · see citing works
Ethnic differences among patients with cutaneous melanoma
Cormier, J. N., Xing, Y., Ding, M., Lee, J. E., Mansfield, P. F., Gershenwald, J. E., Ross, M. I., & Du, X. L. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.17.1907 · Cited by 378 · see citing works
Optenberg, S. A. (1995) · JAMA · doi:10.1001/jama.1995.03530200035033 · Cited by 253 · see citing works
Age and gender are significant independent predictors of survival in primary cutaneous melanoma
Lasithiotakis, K. G., Leiter, U., Meier, F. E., Eigentler, T., Metzler, G., Moehrle, M., Breuninger, H., & Garbe, C. (2008) · Cancer · doi:10.1002/cncr.23359 · Cited by 246 · see citing works
Patient Demographic and Socioeconomic Characteristics in the SEER-Medicare Database
Bach, P. B., Guadagnoli, E., Schrag, D., Schussler, N. C., & Warren, J. L. (2002) · Medical Care · doi:10.1097/00005650-200208001-00003 · Cited by 245 · see citing works
Gender-Related Differences in Outcome for Melanoma Patients
Scoggins, C. R., Ross, M. I., Reintgen, D. S., Noyes, R. D., Goydos, J. S., Beitsch, P. D., Urist, M. M., Ariyan, S., SUSSMAN, J. S., Edwards, M. J., et al. (2006) · Annals of Surgery · doi:10.1097/01.sla.0000216771.81362.6b · Cited by 197 · see citing works
Zell, J. A., Cinar, P., Mobasher, M., Ziogas, A., Meyskens, F. L., & Anton-Culver, H. (2008) · Journal of Clinical Oncology · doi:10.1200/jco.2007.12.3604 · Cited by 176 · see citing works
Shavers, V. L., Harlan, L. C., Winn, D. M., & Davis, W. W. (2003) · Cancer and Metastasis Reviews · doi:10.1023/a:1022255800411 · Cited by 140 · see citing works
Explaining racial differences in prostate cancer in the United States: Sociology or biology?
Freedland, S. J., & Isaacs, W. B. (2004) · The Prostate · doi:10.1002/pros.20052 · Cited by 138 · see citing works
Age as a prognostic factor in the malignant melanoma population
Austin, P. F., Cruse, C. W., Lyman, G. H., Schroer, K. R., Glass, F., & Reintgen, D. S. (1994) · Annals of Surgical Oncology · doi:10.1007/bf02303614 · Cited by 126 · see citing works
MacKie, R. M., & Hole, D. J. (1996) · BMJ · doi:10.1136/bmj.312.7039.1125 · Cited by 115 · see citing works
Impact of socioeconomic status on prostate cancer diagnosis, treatment, and prognosis
Rapiti, E., Fioretta, G., Schaffar, R., Neyroud‐Caspar, I., Verkooijen, H. M., Schmidlin, F. R., Miralbell, R., Zanetti, R., & Bouchardy, C. (2009) · Cancer · doi:10.1002/cncr.24607 · Cited by 100 · see citing works
Development of prognostic factors and survival in cutaneous melanoma over 25 years
Buettner, P. G., Leiter, U., Eigentler, T., & Garbe, C. (2005) · Cancer · doi:10.1002/cncr.20816 · Cited by 97 · see citing works
Tree-structured prediction for censored survival data and the cox model
Ciampi, A. (1995) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(94)00164-l · Cited by 93 · see citing works
Mandalà, M., Imberti, G. L., Piazzalunga, D., Belfiglio, M., Labianca, R., Barberis, M. C. P., Marchesi, L., Poletti, P. L., Bonomi, L., Novellino, L., et al. (2009) · European Journal of Cancer · doi:10.1016/j.ejca.2009.05.034 · Cited by 92 · see citing works
Self-citationCutaneous melanoma mortality among the socioeconomically disadvantaged in Massachusetts.
Geller, A. C., Miller, D. R., Lew, R. A., Clapp, R., Wenneker, M. B., & Koh, H. K. (1996) · American Journal of Public Health · doi:10.2105/ajph.86.4.538 · Cited by 85 · see citing works
Birch‐Johansen, F., Hvilsom, G. B., Kjær, T. K., & Storm, H. H. (2008) · European Journal of Cancer · doi:10.1016/j.ejca.2008.06.016 · Cited by 52 · see citing works
Education, socioeconomic status and risk of cancer of the colon and rectum
Tavani, A., Fioretti, F., Franceschi, S., Gallus, S., Negri, E., Montella, M., Conti, E., & Vecchia, C. L. (1999) · International Journal of Epidemiology · doi:10.1093/ije/28.3.380 · Cited by 43 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Socioeconomic and lifestyle factors and melanoma: a systematic review
Jiang, A. J., Rambhatla, P. V., & Eide, M. J. (2014) · British Journal of Dermatology · doi:10.1111/bjd.13500 · Cited by 165 · see citing works
Svedman, F. C., Pillas, D., Kaur, M., Linder, R., Hansson, J., & Taylor, A. (2016) · Clinical Epidemiology · doi:10.2147/clep.s99021 · Cited by 116 · see citing works
Use of Smartphones for Early Detection of Melanoma: Systematic Review
Rat, C., Hild, S., Rault Sérandour, J., Gaultier, A., Quereux, G., Dreno, B., & Nguyen, J.-M. (2018) · Journal of Medical Internet Research · doi:10.2196/jmir.9392 · Cited by 107 · see citing works
“Numerous factors associated with a delayed diagnosis are patient-related [4-12].”
Eriksson, H., Lyth, J., Månsson‐Brahme, E., Frohm‐Nilsson, M., Ingvar, C., Lindholm, C., Naredi, P. L. J., Stierner, U. K., Wagenius, G., Carstensen, J. M., et al. (2013) · European Journal of Cancer · doi:10.1016/j.ejca.2013.03.013 · Cited by 79 · see citing works
Eriksson, H., Lyth, J., Månsson‐Brahme, E., Frohm‐Nilsson, M., Ingvar, C., Lindholm, C., Naredi, P. L. J., Stierner, U. K., Carstensen, J. M., & Hansson, J. (2014) · Journal of Clinical Oncology · doi:10.1200/jco.2013.52.7564 · Cited by 53 · see citing works
Role of obesity on the thickness of primary cutaneous melanoma
Skowron, F., Bérard, F., Balme, B., & Maucort‐Boulch, D. (2014) · Journal of the European Academy of Dermatology and Venereology · doi:10.1111/jdv.12515 · Cited by 53 · see citing works
Acral melanoma: a retrospective cohort from the Brazilian National Cancer Institute (INCA)
Nunes, L. F., Mendes, G. L. Q., & Koifman, R. J. (2018) · Melanoma Research · doi:10.1097/cmr.0000000000000476 · Cited by 38 · see citing works
Roy, A., Mehra, S., Kelly, C. P., Tariq, S., Pallav, K., Dennis, M. D., Peer, A., Lebwohl, B., Green, P. H. R., & Leffler, D. A. (2016) · Therapeutic Advances in Gastroenterology · doi:10.1177/1756283x16637532 · Cited by 37 · see citing works
Sun Exposure and Melanoma Survival: A GEM Study
Berwick, M., Reiner, A. S., Paine, S., Armstrong, B. K., Kricker, A., Goumas, C., Cust, A. E., Thomas, N. E., Groben, P. A., From, L., et al. (2014) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-14-0431 · Cited by 36 · see citing works
Sun exposure and melanoma prognostic factors
Gandini, S., Montella, M., Ayala, F., Benedetto, L., Rossi, C. R., Vecchiato, A., Corradin, M. T., GIORGI, V. D., Queirolo, P., Zannetti, G., et al. (2016) · Oncology Letters · doi:10.3892/ol.2016.4292 · Cited by 37 · see citing works
Roetzheim, R. G., Lee, J.-H., Ferrante, J. M., Gonzalez, E. C., Chen, R., Fisher, K. J., Love-Jackson, K., & McCarthy, E. P. (2013) · The Journal of the American Board of Family Medicine · doi:10.3122/jabfm.2013.06.130042 · Cited by 32 · see citing works
Efficacy of a general practitioner training campaign for early detection of melanoma in France
Grange, F., Woronoff, A., Bera, R., Colomb, M., Lavole, B., Fournier, E., Arnold, F., & Barbe, C. (2013) · British Journal of Dermatology · doi:10.1111/bjd.12585 · Cited by 32 · see citing works
Körner, A., Coroiu, A., Martins, C., & Wang, B. (2013) · International Archives of Medicine · doi:10.1186/1755-7682-6-8 · Cited by 31 · see citing works
Grange, F., Barbe, C., Aubin, F., Lipsker, D., Granel-Brocard, F., Velten, M., Dalac, S., Truchetet, F., Michel, C., Mitschler, A., et al. (2012) · Archives of Dermatology · doi:10.1001/archdermatol.2012.2937 · Cited by 29 · see citing works
Socioeconomic status as a predictor of melanoma survival in a series of 1083 cases from Brazil
Mendes, G. L. Q., & Koifman, S. (2013) · Melanoma Research · doi:10.1097/cmr.0b013e32835e76f8 · Cited by 22 · see citing works
Gandini, S., de Vries, E., Tosti, G., Botteri, E., Spadola, G., Maisonneuve, P., Martinoli, C., Joosse, A., Ferrucci, P. F., Baldini, F., et al. (2013) · PLoS ONE · doi:10.1371/journal.pone.0078820 · Cited by 18 · see citing works
Cutaneous melanoma in Argentina: an analysis of its characteristics and regional differences
Loria, D., Abriata, G., Santoro, F., & Latorre, C. (2020) · ecancermedicalscience · doi:10.3332/ecancer.2020.1017 · Cited by 17 · see citing works
Kiuru, M. H., Li, Q., Zhu, G., Terrell, J. R., Beroukhim, K., Maverakis, E., & Keegan, T. H. M. (2022) · Journal of the European Academy of Dermatology and Venereology · doi:10.1111/jdv.18458 · Cited by 14 · see citing works
Host Characteristics and Risk of Incident Melanoma by Breslow Thickness
Li, W., Cho, E., Wu, S., Li, S., Matthews, N. H., & Qureshi, A. A. (2018) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-18-0607 · Cited by 13 · see citing works
Melanoma Early Detection and Awareness
Wainstein, A. J. A., Martín‐Algarra, S., Bastholt, L., Cinat, G., Демидов, Л. В., Grob, J., Guo, J., Hersey, P., Espinosa, E., Schachter, J., et al. (2014) · American Journal of Therapeutics · doi:10.1097/mjt.0000000000000038 · Cited by 12 · see citing works
Roumen, R. M. H., Schuurman, M. S., Aarts, M. J., Maaskant-Braat, A. J. G., Vreugdenhil, G., & Louwman, M. W. J. (2021) · PLoS ONE · doi:10.1371/journal.pone.0252021 · Cited by 10 · see citing works
Socioeconomic and Ethnic Disparities in Periocular Cutaneous Malignancies
Broadbent, T. J., Bingham, B. S., & Mawn, L. A. (2016) · Seminars in Ophthalmology · doi:10.3109/08820538.2016.1154172 · Cited by 9 · see citing works
Borghi, A., Corazza, M., Virgili, A., Lambertini, A. G., Caranci, N., Pacelli, B., Carcoforo, P., & Ferretti, S. (2017) · Melanoma Research · doi:10.1097/cmr.0000000000000378 · Cited by 8 · see citing works
Borroni, R. G., Panasiti, V., Valenti, M., Gargiulo, L., Perrone, G., Dall’Alba, R., Fava, C., Sacrini, F., Mancini, L. L., Manara, S. A. A. M., et al. (2023) · Cancers · doi:10.3390/cancers15041129 · Cited by 8 · see citing works
Rat, C., Quereux, G., Grimault, C., Fernandez, J., Poiraud, M., Gaultier, A., Chaslerie, A., Pivette, J., Khammari, A., Dréno, B., et al. (2016) · Scandinavian Journal of Primary Health Care · doi:10.1080/02813432.2016.1207149 · Cited by 7 · see citing works
The benefit of sentinel lymph node biopsy in elderly patients with melanoma
Shen, N., Ramanathan, S., Horns, J. J., Hyngstrom, J. R., Bowles, T. L., Grossman, D., & Asare, E. A. (2024) · The American Journal of Surgery · doi:10.1016/j.amjsurg.2024.115896 · Cited by 6 · see citing works
Late-Stage Melanoma: Be Sure to Screen Uninsured, Unmarried Men
Valentin, V. L., Sanderson, W. T., Westneat, S., & Durbin, E. B. (2018) · Southern Medical Journal · doi:10.14423/smj.0000000000000888 · Cited by 6 · see citing works
Clinical-epidemiological studies on cutaneous malignant melanoma : A register approach
Lyth, J. (2015) · Linköping University medical dissertations · doi:10.3384/diss.diva-113145 · Cited by 2 · see citing works
Which factors influence the participation in statutory skin cancer screenings in Germany?
Andrees, V., Wolf, S., Liebers, J., Augustin, M., & Girbig, G. (2024) · JDDG Journal der Deutschen Dermatologischen Gesellschaft · doi:10.1111/ddg.15421 · Cited by 2 · see citing works
Welche Faktoren beeinflussen die Teilnahme am gesetzlichen Hautkrebsscreenings in Deutschland?
Andrees, V., Wolf, S., Liebers, J., Augustin, M., & Girbig, G. (2024) · JDDG Journal der Deutschen Dermatologischen Gesellschaft · doi:10.1111/ddg.15421_g · Cited by 2 · see citing works
Racial and Socioeconomic Disparities in Melanoma Incidence Rates in Georgia: 2000-2011
Culp, M. B., Robb, S. W., Bayakly, A. R., & Vena, J. E. (2015) · Journal of the Georgia Public Health Association · doi:10.20429/jgpha.2015.050202 · Cited by 1 · see citing works
Martínez, G., Bobadilla, F., Kinzel, F., Fernández, J., Ivo Sazunic, Y., Delgado, M. M., Segovia, L., Zamudio, A., & Vega, N. (2023) · Dermatology Practical & Conceptual · doi:10.5826/dpc.1304a273 · Cited by 1 · see citing works
Geimer, T. (2011) · Elektronische Hochschulschriften der LMU München (Ludwig-Maximilians-Universität München) · doi:10.5282/edoc.13744
Clinical and epidemiological studies on prognostic and predicitve factors in cutaneous melanoma
Eriksson, H. (2013) · Figshare
Condrat, C. E., Dobrica, E. C., Creţoiu, S. M., & Crețoiu, D. (2022) · Wiley eBooks · doi:10.1002/9781119807704.ch14
Melanoma in Chile: demographics and clinico-pathological features
Hein, E. C. K., Villanueva, F., Vilbert, M., Araya, V., Abarzúa, Á., Antúnez-Lay, A. C., Cárdenas, C., Castro, J. C., Dominguez, F., Droppelmann, K., et al. (2025) · Frontiers in Oncology · doi:10.3389/fonc.2025.1604442
Marqueurs prédictifs de réponse aux inhibiteurs de BRAF dans le mélanome cutané métastatique
Funck-Brentano, E. (2016) · theses.fr (ABES) · doi:10.70675/73a2af67z6d03z483czb461zb0527aec1a30
Kim, H. E., Kim, J., Lee, D. H., Shim, H. J., & Yun, S. J. (2026) · Melanoma Research · doi:10.1097/cmr.0000000000001126
Living alone and mortality risk in cancer patients: a systematic review and meta-analysis
Huang, J., Tu, Z., Wu, D., Liu, F., & Du, L. (2026) · Frontiers in Oncology · doi:10.3389/fonc.2026.1866474
- Authors
- Mandalà, M., Imberti, G. L., Piazzalunga, D., Belfiglio, M., Lucisano, G., Labianca, R., Marchesi, L., Merelli, B., Robone, S., Poletti, P., Milesi, L., & Tondini, C.
- Affiliations
- Mario Negri Sud Foundation (IT)
- University of York (GB)
- Corresponding author
- Mandalà, Mario
- Venue
- Mayo Clinic Proceedings
- Publisher
- Elsevier BV
- Published
- 2011-02
- Volume
- 86
- Issue
- 2
- Pages
- 113-119
- ISSN
- 0025-6196 (ISSN-L)
- PMC
- PMC3031435
- OpenAlex
- W2053350362
- Cited by
- 42
- References
- 24
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 3 · 2023: 2 · 2022: 3 · 2021: 1 · 2020: 1 · 2018: 4 · 2017: 2 · 2016: 6 · 2015: 3 · 2014: 5 · 2013: 7 · 2012: 1
- FWCI
- 2.20
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Mayo Clinic Proceedings (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
- IrInSubria (University of Insubria) (submittedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Cutaneous Melanoma Detection and Management
- Health Sciences › Medicine › Epidemiology › Nonmelanoma Skin Cancer Studies
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Keywords
- socioeconomic status, primary cutaneous melanoma, Breslow thickness, disease-free survival, overall survival, melanoma thickness, living arrangements, family environment, sex differences, educational attainment
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Italy, Longitudinal Studies, Male, Melanoma, Middle Aged, Skin Neoplasms, Social Class, Survival Rate, Multivariate Analysis, Logistic Models, Proportional Hazards Models, Disease-Free Survival
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
