Sex Differences in Loss in Life Expectancy in Primary Cutaneous Melanoma, a Swedish Cohort Study

Authors

  • Anna Oksanen Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
  • Elisavet Syriopoulou Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
  • Kari Nielsen Department of Dermatology, Skåne University Hospital, Lund, Sweden; Department of Clinical Sciences, Dermatology, Lund University Skin Cancer Research Group, and Lund Melanoma Study Group, Lund University, Lund, Sweden
  • Hanna Eriksson Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden; Theme Cancer, Unit of Head-Neck-, Lung- and Skin Cancer, Skin Cancer Center, Karolinska University Hospital, Stockholm, Sweden https://orcid.org/0000-0001-6728-5344
  • Therese Andersson Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

DOI:

https://doi.org/10.2340/actadv.v106.adv-2025-0227

Keywords:

Cutaneous malignant melanoma, Life Expectancy, Mortality

Abstract

Sex differences in cutaneous melanoma (CM) survival are pronounced. It is unclear how these differences impact the loss in life expectancy (LLE). A population-based cohort from the Swedish Melanoma registry was used to analyze sex differences in life expectancy (LE) and LLE following a CM diagnosis. The cohort included 12 ,893 men and 12 ,572 women aged 40 years or above diagnosed with a first invasive CM in Sweden between 2000 and 2014. The average remaining LE at CM diagnosis was 15.45 years (95% CI 15.21, 15.7) for men and 20.14 years (95% CI 19.89, 20.43) for women, and the LLE was 2.95 years (95% CI 2.70, 3.19) and 2.4 years (95% CI 2.11, 2.67), respectively. If men had the same relative survival as women, the average LE for men would instead be 17.33 years (95% CI 17.03, 17.65) and the LLE 1.07 years (95% CI 1.07, 1.38). Men lose more years due to CM than women. Baseline age, stage or location are not sufficient to explain the sex differences.

Downloads

Download data is not yet available.

References

Joosse A, Collette S, Suciu S, Nijsten T, Lejeune F, Kleeberg UR, et al. Superior outcome of women with stage I/II cutaneous melanoma: pooled analysis of four European Organisation for Research and Treatment of Cancer phase III trials. J Clin Oncol 2012; 30: 2240–2247. DOI: https://doi.org/10.1200/JCO.2011.38.0584

Joosse A, Collette S, Suciu S, Nijsten T, Patel PM, Keilholz U, et al. Sex is an independent prognostic indicator for survival and relapse/progression-free survival in metastasized stage III to IV melanoma: a pooled analysis of five European organisation for research and treatment of cancer randomized controlled trials. J Clin Oncol 2013; 31: 2337–2346. DOI: https://doi.org/10.1200/JCO.2012.44.5031

Schwartz MR, Luo L, Berwick M. Sex differences in melanoma. Curr Epidemiol Rep 2019; 6: 112–118. DOI: https://doi.org/10.1007/s40471-019-00192-7

White LP. Studies on melanoma. II. Sex and survival in human melanoma. N Engl J Med 1959; 260: 789–797. DOI: https://doi.org/10.1056/NEJM195904162601601

Eriksson H, Lyth J, Månsson-Brahme E, Frohm-Nilsson M, Ingvar C, Lindholm C, et al. Low level of education is associated with later stage at diagnosis and reduced survival in cutaneous malignant melanoma: a nationwide population-based study in Sweden. Eur J Cancer 2013; 49: 2705–2716. DOI: https://doi.org/10.1016/j.ejca.2013.03.013

Crombie IK. Distribution of malignant melanoma on the body surface. Br J Cancer 1981; 43: 842–849. DOI: https://doi.org/10.1038/bjc.1981.123

El Sharouni MA, Witkamp AJ, Sigurdsson V, van Diest PJ, Louwman MWJ, Kukutsch NA. Sex matters: men with melanoma have a worse prognosis than women. J Eur Acad Dermatol Venereol 2019; 33: 2062–2067. DOI: https://doi.org/10.1111/jdv.15760

Andersson TML, Eriksson H, Hansson J, Månsson-Brahme E, Dickman PW, Eloranta S, et al. Estimating the cure proportion of malignant melanoma, an alternative approach to assess long term survival: a population-based study. Cancer Epidemiol 2014; 38: 93–99. DOI: https://doi.org/10.1016/j.canep.2013.12.006

Swedish melanoma registry (SweMR–Svenska Melanomregistret). 2025 Feb 13. Available from: Https:// Cancercentrum.Se/Samverkan/Cancerdiagnoser/Hud-Och- Melanom/Malignt-Melanom/Kvalitetsregister/

Andersson TML, Dickman PW, Eloranta S, Lambe M, Lambert PC. Estimating the loss in expectation of life due to cancer using flexible parametric survival models. Stat Med 2013; 32: 5286–5300. DOI: https://doi.org/10.1002/sim.5943

JE, Scolyer RA, Hess KR, Sondak VK, Long GV, Ross MI, et al. Melanoma staging: evidence-based changes in the American Joint Committee on Cancer eighth edition cancer staging manual. CA Cancer J Clin 2017; 67: 472–492. DOI: https://doi.org/10.3322/caac.21409

Vikström S, Syriopoulou E, Andersson TML, Eriksson H. Loss in life expectancy in patients with stage II-III cutaneous melanoma in Sweden: a population-based cohort study. J Am Acad Dermatol 2024; 90: 963–969. DOI: https://doi.org/10.1016/j.jaad.2023.12.053

Syriopoulou E, Bower H, Andersson TML, Lambert PC, Rutherford MJ. Estimating the impact of a cancer diagnosis on life expectancy by socio-economic group for a range of cancer types in England. Br J Cancer 2017; 117: 1419–1426. DOI: https://doi.org/10.1038/bjc.2017.300

Thiam A, Zhao Z, Quinn C, Barber B. Years of life lost due to metastatic melanoma in 12 countries. J Med Econ 2016; 19: 259–264. DOI: https://doi.org/10.3111/13696998.2015.1115764

Jung KW, Park S, Shin A, Oh CM, Kong HJ, Jun JK, et al. Do female cancer patients display better survival rates compared with males? Analysis of the Korean National Registry data, 2005-2009. PLoS One 2012; 7: e52457. DOI: https://doi.org/10.1371/journal.pone.0052457

Magnus K. Prognosis in malignant melanoma of the skin. Significance of stage of disease, anatomical site, sex, age and period of diagnosis. Cancer 1977; 40: 389–397. DOI: https://doi.org/10.1002/1097-0142(197707)40:1<389::AID-CNCR2820400155>3.0.CO;2-I

Rampen FHJ. Sex differences in survival from cutaneous melanoma. Int J Dermatology 1984; 23: 444–452. DOI: https://doi.org/10.1111/ijd.1984.23.7.444

Malec E, Eklund G. The changing incidence of malignant melanoma of the skin in Sweden, 1959-1968. Scand J Plast Reconstr Surg 1978; 12: 19–27. DOI: https://doi.org/10.3109/02844317809010476

Olsen CM, Thompson JF, Pandeya N, Whiteman DC. Evaluation of sex-specific incidence of melanoma. JAMA Dermatol 2020; 156: 553–560. DOI: https://doi.org/10.1001/jamadermatol.2020.0470

Shaw HM, McGovern VJ, Milton GW, Farago GA, McCarthy WH. Histologic features of tumors and the female superiority in survival from malignant melanoma. Cancer 1980; 45: 1604–1608. DOI: https://doi.org/10.1002/1097-0142(19800401)45:7<1604::AID-CNCR2820450715>3.0.CO;2-O

Smith AJ, Lambert PC, Rutherford MJ. Understanding the impact of sex and stage differences on melanoma cancer patient survival: a SEER-based study. Br J Cancer 2021; 124: 671–677. DOI: https://doi.org/10.1038/s41416-020-01144-5

Yuan TA, Lu Y, Edwards K, Jakowatz J, Meyskens FL, Liu-Smith F. Race-, age-, and anatomic site-specific gender differences in cutaneous melanoma suggest differential mechanisms of early- and late-onset melanoma. Int J Environ Res Public Health 2019; 16: 908. DOI: https://doi.org/10.3390/ijerph16060908

Cosman B, Heddle SB, Crikelair GV. The increasing incidence of melanoma. Plast Reconstr Surg 1976; 57: 50–56. DOI: https://doi.org/10.1097/00006534-197601000-00010

Erdmann F, Lortet-Tieulent J, Schüz J, Zeeb H, Greinert R, Breitbart EW, et al. International trends in the incidence of malignant melanoma 1953-2008--are recent generations at higher or lower risk? Int J Cancer 2013; 132: 385–400. DOI: https://doi.org/10.1002/ijc.27616

Welch HG, Mazer BL, Adamson AS. The rapid rise in cutaneous melanoma diagnoses. N Engl J Med 2021; 384: 72–79. DOI: https://doi.org/10.1056/NEJMsb2019760

Rubin R. Melanoma diagnoses rise while mortality stays fairly flat, raising concerns about overdiagnosis. JAMA 2020; 323: 1429. DOI: https://doi.org/10.1001/jama.2020.2669

Kurtansky NR, Dusza SW, Halpern AC, Hartman RI, Geller AC, Marghoob AA, et al. An epidemiologic analysis of melanoma overdiagnosis in the United States, 1975-2017. J Invest Dermatol 2022; 142: 1804–1811. DOI: https://doi.org/10.1016/j.jid.2021.12.003

Downloads

Additional Files

Published

2026-04-20

How to Cite

Oksanen, A., Syriopoulou, E., Nielsen, K., Eriksson, H., & Andersson, T. (2026). Sex Differences in Loss in Life Expectancy in Primary Cutaneous Melanoma, a Swedish Cohort Study. Acta Dermato-Venereologica, 106, adv–2025. https://doi.org/10.2340/actadv.v106.adv-2025-0227

Issue

Vol. 106 (2026)

Section

Articles

Categories

License

Copyright (c) 2026 Anna Oksanen, Elisavet Syriopoulou, Kari Nielsen, Hanna Eriksson, Therese Andersson

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

All digitalized ActaDV contents is available freely online. The Society for Publication of Acta Dermato-Venereologica owns the copyright for all material published until volume 88 (2008) and as from volume 89 (2009) the journal has been published fully Open Access, meaning the authors retain copyright to their work.

Unless otherwise specified, all Open Access articles are published under CC-BY-NC licences, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for non-commercial purposes, provided proper attribution to the original work.

Crossref
Scopus
Google Scholar
Europe PMC