All of the male and female melanoma patients had been diagnosed with either stage 1 (early) or stage 2 (localized) cancer. During and following treatment, all the patients were tracked for disease remission, relapse, spread and death.
The result: male melanoma patients were found to have worse disease characteristics at diagnosis and worse disease progression.
On the latter measure, female patients were found to have a "highly consistent and independent advantage" over men in terms of overall survival, both before and after menopause.
The sole exception was seen in cases of head and neck melanomas, where the gender differences disappeared. But the team cautioned that even this exception could ultimately be dismissed as misleading, due to key study peculiarities.
It is not that the initial tumor starts out worse in men than women, the authors stressed. Rather it is something gender-related that causes the cancer to unfold in a more deadly way in men.
In theory, estrogen level differences could play a role, although the team noted that the evidence so far suggests the hormone does not have much effect on melanoma.
Other possibilities include gender differences with respect to vitamin D metabolism, immune system function, male testosterone levels and what is known as "oxidative stress" in the body.
"However, our data could not support or disprove any of these hypotheses," Joosse acknowledged.
Sondak said that while the gender gap is probably real, it is likely a function of both biology and environment.
"I believe that the message here is that if you're a man, think like a woman," said Sondak. "And that's because most of us feel that a big part of this has to do with the fact that women are a little more likely to be paying attention to their skin and to notice something on their skin, and most importantly, to do something about it right away. And with melanoma, early detection is key," he stressed
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