Background
Methods
Study design
Independent variables and covariables
Outcome variable (autoimmune disorders)
Statistical analyses
Results
Melanoma n (%)a | Melanoma and Non-Cutaneous Cancer n (%) | Non-Cutaneous Cancer n (%) | No History of Cancerb n (%) | |
---|---|---|---|---|
Total | 6543 | 2046 | 27,630 | 255,114 |
Sex | ||||
Male | 3345 (51.1) | 1039 (50.8) | 11,309 (40.9) | 108,568 (42.6) |
Female | 3198 (48.9) | 1007 (49.2) | 13,736 (59.0) | 146,536 (57.4) |
Undetermined | n/a | n/a | 1 (< 1) | 10 (< 1) |
Age at Presentation, y | ||||
Median | 62 | 64 | 62 | 62 |
18–34 | 393 (6.0) | 67 (3.3) | 1552 (5.6) | 24,415 (9.6) |
35–49 | 1182 (18.1) | 333 (16.3) | 4083 (14.8) | 35,915 (14.1) |
50–64 | 2033 (31.1) | 670 (32.7) | 9529 (34.5) | 83,749 (32.8) |
65–74 | 1376 (21.0) | 476 (23.3) | 5981 (21.6) | 43,892 (17.2) |
75+ | 1559 (23.8) | 500 (24.4) | 6485 (23.5) | 67,143 (26.3) |
Race/ethnicity | ||||
White, non- Hispanic | 5269 (80.5) | 1927 (94.2) | 23,097 (83.6) | 184,554 (72.3) |
Black, non-Hispanic | 16 (< 1) | 33 (1.6) | 2491 (9.0) | 17,818 (6.9) |
Hispanic | 8 (< 1) | 2 (< 1) | 452 (1.6) | 8422 (3.3) |
Asian & Pacific Islander | 8 (< 1) | 3 (< 1) | 291 (1.1) | 3063 (1.2) |
Otherc | 1 (< 1) | n/a | 30 (< 1) | 304 (< 1) |
Unknown | 1241 (19.0) | 81 (4.0) | 1269 (4.6) | 40,953 (16.1) |
Year | ||||
2000–2010 | 4163 (63.6) | 1285 (62.8) | 18,303 (66.2) | 152,542 (59.8) |
2011–2018 | 2380 (36.4) | 761 (37.2) | 9327 (33.8) | 102,572 (40.2) |
Health Insurance | ||||
Medicare | 3370 (51.5) | 1243 (60.8) | 14,836 (53.7) | 113,240 (44.4) |
Medicaid | 135 (2.1) | 75 (3.7) | 2662 (9.6) | 25,418 (10.0) |
Private | 2964 (45.3) | 706 (34.5) | 9764 (35.3) | 108,291 (42.4) |
Self-pay | 74 (1.1) | 22 (1.1) | 367 (1.3) | 8128 (3.2) |
Otherd | n/a | n/a | 1 (< 1) | 37 (< 1) |
Prevalence of autoimmune disorders
Patients with metastatic cancer at diagnosis
Melanoma (n = 116) | Melanoma and Non-Cutaneous Cancer (n = 471) | Non-Cutaneous Cancerb (n = 1698) | |
---|---|---|---|
Autoimmune Prevalence (%)a | 12 (10.3) | 113 (24.0) | 281 (16.5) |
Age at presentation, y | |||
18–34 | 1 (14.3) | 3 (25.0) | 6 (22.2) |
35–49 | 2 (9.1) | 20 (27.0) | 10 (8.9) |
50–64 | 3 (7.1) | 29 (32.2) | 64 (13.1) |
65–74 | 2 (10.5) | 23 (20.1) | 116 (21.4) |
75+ | 3 (12.0) | 38 (31.4) | 87 (16.2) |
Risk factors associated with autoimmunity
Predictor | Unadjusted | Adjusted | ||
---|---|---|---|---|
OR (95% CI) | p-valueb | OR (95% CI) | p-valueb | |
Age | ||||
18–34 | 1.00 | 1.00 | ||
35–49 | 1.43 (1.34–1.52) | < 0.001 | 1.30 (1.22–1.39) | < 0.001 |
50–64 | 1.27 (1.20–1.35) | < 0.001 | 1.38 (1.30–1.46) | < 0.001 |
65–74 | 1.27 (1.19–1.35) | < 0.001 | 1.36 (1.27–1.45) | < 0.001 |
75+ | 1.63 (1.48–1.57) | < 0.001 | 1.78 (1.67–1.89) | < 0.001 |
Sexc | ||||
Male | 1.00 | 1.00 | ||
Female | 1.53 (1.48–1.57) | < 0.001 | 1.53 (1.48–1.57) | < 0.001 |
Racec | ||||
White, non-Hispanic | 1.00 | 1.00 | ||
Black, non-Hispanic | 1.16 (1.10–1.22) | < 0.001 | 1.22 (1.16–1.29) | < 0.001 |
Hispanic | 0.80 (0.74–0.88) | < 0.001 | 1.04 (0.95–1.14) | 1.00 |
Asian/Pacific-Islander | 1.04 (0.91–1.18) | 1.00 | 1.13 (1.00–1.29) | 0.9780 |
Native American/Alaskan Native | 1.68 (1.05–2.68) | 0.529 | 1.72 (1.07–2.78) | 0.4642 |
Multiracial | 0.76 (0.40–1.44) | 1.00 | 1.02 (0.54–1.95) | 1.000 |
Smoker Statusc | ||||
Never Smoker | 1.00 | 1.00 | ||
Current or Past Smoker | 1.07 (1.03–1.11) | 0.015 | 1.08 (1.03–1.12) | 0.005 |
Cancer History | ||||
No History of Cancerd | 1.00 | 1.00 | ||
Melanoma Alone | 1.55 (1.43–1.69) | < 0.001 | 1.59 (1.46–1.73) | < 0.001 |
Melanoma and Non- Cutaneous Cancer | 3.81 (3.41–4.25) | < 0.001 | 3.22 (2.87–3.61) | < 0.001 |
Non-Cutaneous Cancer | 3.00 (2.89–3.10) | < 0.001 | 2.46 (2.37–2.56) | < 0.001 |
Metastases at Diagnosis | ||||
Metastases Absent | 1.00 | |||
Metastases Present | 2.76 (2.48–3.08) | < 0.001 | 1.05 (0.94–1.18) | 1.000 |