Racial disparities in melanoma survival

J Am Acad Dermatol. 2016 Nov;75(5):983-991. doi: 10.1016/j.jaad.2016.06.006. Epub 2016 Jul 28.

Abstract

Background: Melanoma is a cutaneous malignancy common in the white population but can also occur in other racial groups.

Objective: We sought to evaluate survival across racial groups in patients given a diagnosis of malignant melanoma.

Methods: The Surveillance, Epidemiology, and End Results database was used to populate a cohort of 96,953 patients given a diagnosis of cutaneous melanoma as their primary cancer, from 1992 to 2009.

Results: White patients had the longest survival time (P < .05), followed by Hispanic (P < .05), Asian American/Native American/Pacific Islander (P < .05), and black (P < .05) patients, respectively. Survival stratified by race and stage showed that for stages I and III, blacks had a significantly lower survival (P < .05), and increased hazard ratios (stage I hazard ratio, 3.037 [95% confidence interval, 2.335-3.951]; stage III hazard ratio, 1.864 [95% confidence interval, 1.211-2.87]). The proportion of later stage cutaneous melanoma (stages II-IV) was greater in blacks compared with whites.

Conclusion: Despite higher incidence of cutaneous melanoma in whites, overall survival for cutaneous melanoma in non-whites was significantly lower. Our results suggest that more emphasis is needed for melanoma screening and awareness in non-white populations to improve survival outcomes.

Keywords: Asian American/Native American/Pacific Islander; black; epidemiology; health outcomes; melanoma; public health; race; stage; survival; white.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Ethnicity / statistics & numerical data*
  • Female
  • Health Promotion
  • Health Services Needs and Demand
  • Humans
  • Incidence
  • Kaplan-Meier Estimate
  • Male
  • Melanoma / ethnology*
  • Melanoma / mortality
  • Melanoma, Cutaneous Malignant
  • Middle Aged
  • Proportional Hazards Models
  • Racial Groups / statistics & numerical data*
  • SEER Program
  • Skin Neoplasms / ethnology*
  • Skin Neoplasms / mortality
  • Skin Pigmentation
  • Socioeconomic Factors
  • Survival Analysis
  • United States / epidemiology