Socioeconomic and lifestyle factors and melanoma: a systematic review

Jiang, Angela; Rambhatla, Pranita V.; Eide, Melody J.

doi:10.1111/bjd.13500

Cited by 127 publications

(110 citation statements)

References 277 publications

(502 reference statements)

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“…Yet, temporal variations in the geographic patterns of stage-specific incidences and outcome might be an issue of concern as recent temporal changes may have an impact on secondary prevention strategies. Educational level influences CMM stage distribution with low SES linked to melanoma thickness and advanced stage at diagnosis in studies from Europe, the US, Australia and New Zealand [5,6]. In accord with those previous observations, we demonstrated an inverse relationship between stage distribution and educational level with significantly higher fraction of stage I tumors in patients with higher education.…”

Section: Discussionsupporting

confidence: 90%

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Cutaneous malignant melanoma show geographic and socioeconomic disparities in stage at diagnosis and excess mortality

Strömberg

Peterson²,

Holmberg

et al. 2016

Acta Oncologica

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Background Preventive measures are needed to counteract the increasing burden of cutaneous malignant melanoma (CMM). As a basis for rational melanoma prevention, we investigated geographic differences and impact from socioeconomic factors related to incidence, clinical stage at diagnosis and outcome. Material and methods All patients with primary invasive CMM diagnosed in 2004-2013 in the southern and the western Swedish health care regions with a population of 2.9 million adults were eligible for the study. Population-based data were obtained from the national Cancer Register and the national Melanoma Quality Register. Geographic and socioeconomic differences in incidence per stage at diagnosis were mapped and correlated to excess mortality. Results Disease mapping based on 9743 cases in 99 municipalities and 20 metropolitan districts showed marked, regional disparities in stage-specific incidence of CMM. The incidence of stage I-II tumors was higher in the western health care region, whereas the incidence of stage III-IV CMMs was higher in the southern region. The divergent incidence patterns per stage at diagnosis were consistent across population strata based on educational level. The geographic disparities in CMM stage influenced relative survival with an excess five-year mortality ratio in the southern region versus the western region of 1.49 (95% confidence interval 1.22-1.82). The excess mortality ratio for patients with low versus high educational level was 1.81 (1.37-2.40). Conclusion Residential region and educational level influenced CMM stage and, thereby, excess mortality. These observations suggest that geographic as well as socioeconomic data should be considered in prevention of CMM.

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Section: Discussionsupporting

confidence: 90%

“…Socioeconomic status (SES) with disparities related to education, income and occupational status have been described in relation to CMM incidence, morbidity and mortality. High SES has been associated with an increased incidence and low SES has been linked to late diagnosis and an adverse prognosis [5,6].…”

mentioning

confidence: 99%

Cutaneous malignant melanoma show geographic and socioeconomic disparities in stage at diagnosis and excess mortality

Strömberg

Peterson²,

Holmberg

et al. 2016

Acta Oncologica

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“…One explanation may be due to social inequities; further research is needed to fully explore this finding. 4,8,13 …”

Section: Discussionmentioning

confidence: 99%

“…3 Globally, Australia and New Zealand have the highest melanoma incidence. 4 In the United States (U.S.), melanoma incidence is increasing. 5 According to Sandru et al, 6 the likelihood of getting melanoma has increased from 1:1500 in 1935 to 1:50 in 2011.…”

Section: Introductionmentioning

confidence: 99%

Association Between Race/Ethnicity and Survival of Melanoma Patients in the United States Over 3 Decades

et al. 2016

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Melanoma is a treatable and preventable skin cancer. It is responsible for 75% of deaths among all skin cancers. Previous studies have found that race/ethnicity may play a role in survival among melanoma patients. However, there are no studies that cover 30 years and take race into account for the U.S. population.This study is a secondary analysis of the National Cancer Institute's Surveillance, Epidemiology, and End Result (SEER) Program. Adults with primary cutaneous melanoma from 1982 to 2011 were included; the final sample size was 185,219. The outcome was survival; both cause-specific and all-cause mortality were examined. The main exposure was race/ethnicity. Kaplan–Meier survival analysis was used to estimate overall survival. Cox proportional hazards regression was used to estimate unadjusted and adjusted hazard ratios (HRs). A P-value less than 0.05 was considered statistically significant.More than 50% of patients in all races/ethnicities were diagnosed at the in situ or localized stage. Non-Hispanic White patients were more frequently diagnosed at the in situ stage. Overall, more men were diagnosed than women. The majority of cases among all races were men. Non-Hispanic Black females represented the smallest percentage of melanoma cases among all races. The smallest number of diagnoses across all races/ethnicities was made from 1982 to 1991. Median follow-up was 81 months and no collinearity was observed in the adjusted models. When examining cause-specific mortality and controlling for site and stage at diagnosis, gender, age and decade of diagnosis, the HR for non-Hispanic Black patients was lower than that for non-Hispanic White patients (HR 0.7; 95% confidence interval (CI): 0.6–0.8). However, when examining all-cause mortality, this difference disappeared (HR 1.1; 95% CI: 1.0–1.2). Stage at diagnosis impacted HR; patients diagnosed with distant metastases had significantly worse survival.When taking cause-specific mortality into consideration and after controlling for stage and site at diagnosis, gender, and age and decade of diagnosis, non-Hispanic Black patients had a lower HR compared to non-Hispanic White patients. However, this difference disappeared when examining all-cause mortality. Further research is needed to explore this finding and to determine what factors may be associated with late-stage melanoma diagnosis.

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“…People with low SES present with later-stage disease at diagnosis and worse prognosis [34]. Moreover, national socioeconomic parameters were found to influence the survival of cancer patients in Europe [35].…”

Section: Discussionmentioning

confidence: 99%

Survival of patients with skin melanoma in Europe increases further: Results of the EUROCARE-5 study

Crocetti¹,

Robsahm

Lopez

et al. 2015

European Journal of Cancer

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Socioeconomic and lifestyle factors and melanoma: a systematic review

Cited by 127 publications

References 277 publications

Cutaneous malignant melanoma show geographic and socioeconomic disparities in stage at diagnosis and excess mortality

Cutaneous malignant melanoma show geographic and socioeconomic disparities in stage at diagnosis and excess mortality

Association Between Race/Ethnicity and Survival of Melanoma Patients in the United States Over 3 Decades

Survival of patients with skin melanoma in Europe increases further: Results of the EUROCARE-5 study

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