Analysis of Melanoma in African American Patients in the United States

Abstract

Background/Aim: To characterize the demographics, tumor staging and treatment of African American (AA) patients diagnosed with melanoma in the United States. Patients and Methods: The National Cancer Database was used to extrapolate data from patients with melanoma between January 1, 2004, and December 31, 2015. The patients were then further divided based on ethnicity (AAs vs. Caucasians) to compare patient efficacy of treatment. Results: The mean time for AA patients to receive treatment was 20.37 days compared with 11.25 days for Caucasians (p<0.001), while time to surgery was 38.86 days compared to 31.12 days for Caucasians (p<0.001). Moreover, AA race was a predictor of American Joint Committee on Cancer stage greater than II, tumor diagnosed at autopsy, presence of ulceration, and distribution in the extremities. Conclusion: AA patients with melanoma are more likely to have worse tumor staging, treatment delay, treatment at an Integrated Cancer Program, and diagnosis at autopsy. African American's (AA) have a decreased likelihood of developing melanoma when compared to other ethnicities due to the protective action of melanin (1). The incidence of melanoma amongst AAs is 1 to 1.2 per 100,000 (2). However, melanoma in AA patients is frequently diagnosed at an advanced stage due to the difficulty in differentiating between skin tone and cancer combined with lower socioeconomic levels (3, 4). In addition, melanoma survival is lower in AA patients undergoing surgical treatment compared to all other ethnicities (5). Etiologies of these disparities are difficult to assess and poorly understood (1-5). Treatment disparity in minority populations is a debated topic that deserves attention from the scientific community (6). In this study, we aimed to assess the difference in melanoma characteristics, patient population, tumor staging and treatment in AA compared to the Caucasian population. Furthermore, we speculated that significant differences exist between the two populations. Patients and MethodsThis study was considered nonregulated by the institutional review board. The National Cancer Database (NCDB), an initiative driven by the American Cancer Society and the American College of Surgeons' Commission on Cancer that registers 70% of all cancers diagnosed in the USA, was used to extrapolate data (7, 8).Eligible patients were identified according to the NCDB's variable "Race". Data were extracted for all patients diagnosed with melanoma between January 1, 2004, and December 31, 2015. The cohort was then split into two groups based on race: 1) AA or 2) Caucasian. Patients identified with others races, such as Asian or Native American, were excluded as this analysis focused on the comparison between AA patients and Caucasian patients, the largest cohort of patients with melanoma.Data was extracted on patient demographics, facility/treatment type, and tumor characteristics. Patients demographics included age, sex, insurance (Uninsured, Private, Medicaid, Medicare, Other Government, Unknown), and population density (...

Acral lentiginous melanoma: A retrospective study

“…The signs and symptoms that encouraged a fast consultation of a healthcare professional were the late ones, such as bleeding, whereas observing the standard ABCDE signs led to delay in seeking medical attention. 30,31,[48][49][50][51][52][53] Boriani et al 32 showed that higher aggressiveness of ALM is due to the diagnostic delay and the more advanced thickness at diagnosis.…”

“…Substantially, the studies of Richards et al 28,29 found that despite the existence of media operation to promote prevention, 25% of the patients believed that removing a tumor was dangerous, only 24.8% were conscious about the gravity of melanoma, and others just assumed that a lesion could not be malignant if asymptomatic. The signs and symptoms that encouraged a fast consultation of a healthcare professional were the late ones, such as bleeding, whereas observing the standard ABCDE signs led to delay in seeking medical attention 30,31,48‐53 …”

Análise Da Exposição a Fatores De Risco Extrínsecos Associados Ao Envelhecimento Da Pele Em Universitários

“…Importante mencionar que 136 (45,6%) indivíduos estudados declararam-se brancos, seguidos de 96 (32,2%) pardos e 54 (18,1%) declararam-se negros. Sabidamente indivíduos com menor concentração de melanina apresentam uma maior susceptibilidade para o desenvolvimento de cânceres e tumores de pele, especialmente o melanoma (BOCZAR et al, 2019;DE MELO et al, 2018;MAHENDRARAJ et al, 2017). A população do nosso estudo é predominantemente jovem e é importante mencionar que dentre os cânceres mais frequentes em adultos jovens, o melanoma é o segundo mais frequente (BARR et al,2006).…”

Skin Cancer in People of Color

“…Then, when acral lentiginous melanoma is accurately diagnosed, the prognosis is often poor, with a 5-year survival rate of less than 50% in Black individuals (Davis et al, 2021). Melanoma is often overlooked in Black individuals because of misinformation regarding risk, location, and the difficulty in differentiating melanoma from the patients' natural skin color (Boczar et al, 2019). Furthermore, patients' lack of awareness regarding the risk of skin cancer for Black individuals often delays treatment, resulting in an increased likelihood of death when diagnosed (Hall & Rapini, 2020).…”