Backgrounds and methods: American Indian and Alaska Native (AI/AN) populations face significant health disparities across multiple cancer types, yet melanoma-specific outcomes remain under-investigated. A comprehensive search of Embase, Scopus, and PubMed identified 20 studies meeting inclusion criteria. Three meta-analyses were conducted using random effects models to assess: (1) adjusted hazard ratios for mortality risk, (2) adjusted odds ratios for late-stage diagnosis, and (3) age-adjusted incidence rates.
Results: The meta-analysis revealed significant disparities in melanoma outcomes for AI/AN patients. AI/AN patients demonstrated a 43% higher mortality risk compared to white patients (pooled aHR = 1.43, 95% CI: 1.12-1.82, p = 0.0041) and a 75% higher likelihood of late-stage diagnosis (pooled adjusted OR = 1.75, 95% CI: 1.16-2.65, p = 0.0080). AI/AN patients consistently presented with worse prognostic factors including higher Breslow thickness, increased ulceration rates, and more advanced disease stages.
Conclusion: This study provides the first meta-analytic evidence demonstrating statistically significant disparities in melanoma outcomes among AI/AN populations. Systemic barriers include insurance disparities, geographic isolation, treatment delays, and limited access to specialized dermatologic care.
Discussion: These findings justify targeted interventions including enhanced screening programs, improved healthcare infrastructure, and policy reforms to address insurance and access barriers affecting AI/AN communities.
Keywords: American Indian and Alaska Native; Native Americans; disparities outcomes; health disparities; melanoma; meta‐analysis; skin cancer.
© 2025 The Author(s). Journal of Surgical Oncology published by Wiley Periodicals LLC.