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Anders Kjærsgaard

The association between partner bereavement and melanoma: cohort studies in the U.K. and Denmark

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

Dokumenter

  • bjd.18889

    Forlagets udgivne version, 605 KB, PDF-dokument

DOI

  • A. Y.S. Wong, London School of Hygiene and Tropical Medicine
  • ,
  • T. Frøslev
  • L. Dearing, London School of Hygiene and Tropical Medicine
  • ,
  • H. J. Forbes, London School of Hygiene and Tropical Medicine, Health Data Research UK
  • ,
  • A. Mulick, London School of Hygiene and Tropical Medicine
  • ,
  • K. E. Mansfield, London School of Hygiene and Tropical Medicine
  • ,
  • R. J. Silverwood, London School of Hygiene and Tropical Medicine, University College London
  • ,
  • A. Kjærsgaard
  • H. T. Sørensen
  • L. Smeeth, London School of Hygiene and Tropical Medicine, Health Data Research UK
  • ,
  • A. Lewin, London School of Hygiene and Tropical Medicine
  • ,
  • S. A.J. Schmidt
  • S. M. Langan, London School of Hygiene and Tropical Medicine, Health Data Research UK

Background: Psychological stress is commonly cited as a risk factor for melanoma, but clinical evidence is limited. Objectives: This study aimed to evaluate the association between partner bereavement and (i) first-time melanoma diagnosis and (ii) mortality in patients with melanoma. Methods: We conducted two cohort studies using data from the U.K. Clinical Practice Research Datalink (1997–2017) and Danish nationwide registries (1997–2016). In study 1, we compared the risk of first melanoma diagnosis in bereaved vs. matched nonbereaved people using stratified Cox regression. In study 2 we estimated hazard ratios (HRs) for death from melanoma in bereaved compared with nonbereaved individuals with melanoma using Cox regression. We estimated HRs separately for the U.K. and for Denmark, and then pooled the data to perform a random-effects meta-analysis. Results: In study 1, the pooled adjusted HR for the association between partner bereavement and melanoma diagnosis was 0·88 [95% confidence interval (CI) 0·84–0·92] across the entire follow-up period. In study 2, we observed increased melanoma-specific mortality in people experiencing partner bereavement across the entire follow-up period (HR 1·17, 95% CI 1·06–1·30), with the peak occurring during the first year of follow-up (HR 1·31, 95% CI 1·07–1·60). Conclusions: We found decreased risk of melanoma diagnosis, but increased mortality associated with partner bereavement. These findings may be partly explained by delayed detection resulting from the loss of a partner who could notice skin changes. Stress may play a role in melanoma progression. Our findings indicate the need for a low threshold for skin examination in individuals whose partners have died.

OriginalsprogEngelsk
TidsskriftBritish Journal of Dermatology
Vol/bind183
Nummer4
Sider (fra-til)673-683
Antal sider11
ISSN0007-0963
DOI
StatusUdgivet - okt. 2020

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