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The association between partner bereavement and melanoma: cohort studies in the UK and Denmark

Wong, AYS; Froslev, T; Dearing, L; Forbes, HJ; Mulick, A; Mansfield, KE; Silverwood, RJ; ... Langan, SM; + view all (2020) The association between partner bereavement and melanoma: cohort studies in the UK and Denmark. British Journal of Dermatology 10.1111/bjd.18889. (In press). Green open access

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Abstract

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.

Type: Article
Title: The association between partner bereavement and melanoma: cohort studies in the UK and Denmark
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/bjd.18889
Publisher version: https://doi.org/10.1111/bjd.18889
Language: English
Additional information: © 2020 The Authors. British Journal of Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists. This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/).
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Education
UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education
UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education > IOE - Social Research Institute
URI: https://discovery.ucl.ac.uk/id/eprint/10094716
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