Distinct presentation of melanoma in Black patients may inform strategies to improve outcomes

J Surg Oncol. 2024 May;129(6):1041-1050. doi: 10.1002/jso.27608. Epub 2024 Mar 4.


Introduction: Melanoma guidelines stem largely from data on non-Hispanic White (NHW) patients. We aimed to identify features of melanoma within non-Hispanic Black (NHB) patients to inform strategies for earlier detection and treatment.

Methods: From 2004 to 2019 Surveillance, Epidemiology, and End Results (SEER) data, we identified nonmetastatic melanoma patients with known TN category and race. Kaplan-Meier cancer-specific survival (CSS) estimates and multivariable Cox proportional hazard modeling analyses were performed.

Results: Of 492 597 patients, 1499 (0.3%) were NHB, who were younger (21% vs. 17% age <50) and more commonly female (54% vs. 41%) than NHW, both p < 0.0005. For NHBs, lower extremity was the most common site (52% vs. 15% for NHWs, p < 0.0001), T category was higher (55% Tis-T1 vs. 82%; 27% T3-T4 vs. 8%, p < 0.0001) and stage at presentation was higher (19% Stage III, vs. 6%, p < 0.0001). Within the NHB cohort, males were older, and more often node-positive than females. Five-year Stage III CSS was 42% for NHB males versus 71% for females, adjusting for age and clinical nodal status (hazard ratio 2.48).

Conclusions: NHB melanoma patients presented with distinct tumor characteristics. NHB males with Stage III disease had inferior CSS. Focus on this high-risk patient cohort to promote earlier detection and treatment may improve outcomes.

Keywords: ethnic and racial minorities; melanoma; skin neoplasms.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Black or African American* / statistics & numerical data
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Melanoma* / ethnology
  • Melanoma* / mortality
  • Melanoma* / pathology
  • Melanoma* / therapy
  • Middle Aged
  • Prognosis
  • SEER Program*
  • Skin Neoplasms* / ethnology
  • Skin Neoplasms* / mortality
  • Skin Neoplasms* / pathology
  • Skin Neoplasms* / therapy
  • Survival Rate