The ongoing racial disparities in melanoma: An analysis of the Surveillance, Epidemiology, and End Results database (1975-2016)

J Am Acad Dermatol. 2021 Jun;84(6):1585-1593. doi: 10.1016/j.jaad.2020.08.097. Epub 2020 Aug 27.

Abstract

Background: Although most patients with cutaneous melanoma are non-Hispanic whites (NHWs), minorities consistently suffer worse melanoma-specific survival (MSS). Much of the literature comes from analyses of registries from the 1990s and 2000s.

Objective: We sought to evaluate whether and to what degree racial disparity in MSS persists since 2010.

Methods: We analyzed 381,035 patients from the Surveillance, Epidemiology, and End Results registry. Race categories included Hispanic, NHW, non-Hispanic black (NHB), non-Hispanic Asian or Pacific Islander (NHAPI), and non-Hispanic American Indian/Alaska Native (NHAIAN). We evaluated the association between MSS and race in 3 time periods: before the year 2000, 2000 to 2009, and 2010 or later. NHW was the reference group for all analyses.

Results: Racial disparity worsened from before the year 2000 to 2010 or later for Hispanic (P < .001), NHB (P = .024), and NHAPI (P < .001) patients. Across all minority groups, patients with localized disease suffered increasing disparity (P = .010 for Hispanic, P < .001 for NHB, P = .023 for NHAPI, and P = .042 for NHAIAN patients). Among those with regional and distant disease, Hispanic patients were the only minority to experience worsening disparity (P = .001 and P = .019, respectively).

Limitations: Lack of immunotherapy and targeted treatment information.

Conclusions: Racial disparity in MSS is worsening. Improving postdiagnosis management for minorities with localized disease is imperative to mitigate disparity and improve survival.

Keywords: SEER; disparities; melanoma; race/ethnicity; survival.

MeSH terms

  • Adult
  • Aged
  • Asian / statistics & numerical data
  • Black or African American / statistics & numerical data
  • Female
  • Health Status Disparities*
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Male
  • Melanoma / diagnosis
  • Melanoma / mortality*
  • Melanoma / therapy
  • Middle Aged
  • Minority Groups / statistics & numerical data*
  • Native Hawaiian or Other Pacific Islander / statistics & numerical data
  • SEER Program / statistics & numerical data
  • Skin Neoplasms / diagnosis
  • Skin Neoplasms / mortality*
  • Skin Neoplasms / therapy
  • United States / epidemiology
  • White People / statistics & numerical data