The expanding melanoma burden in California hispanics

Abstract

BACKGROUND:The incidence patterns and socioeconomic distribution of cutaneous melanoma among Hispanics are poorly understood. METHODS: The authors obtained population-based incidence data for all Hispanic and nonHispanic white (NHW) patients who were diagnosed with invasive cutaneous melanoma from 1988 to 2007 in California. By using a neighborhood-level measure of socioeconomic status (SES), the variables investigated included incidence, thickness at diagnosis, histologic subtype, anatomic site, and the relative risk (RR) for thicker (>2 mm) versus thinner ( 2 mm) tumors at diagnosis for groups categorized by SES. RESULTS: Age-adjusted melanoma incidence rates per million were higher in NHWs (P < .0001), and tumor thickness at diagnosis was greater in Hispanics (P < .0001). Sixty-one percent of melanomas in NHWs occurred in the High SES group. Among Hispanics, only 35% occurred in the High SES group; and 22% occurred in the Low SES group. Lower SES was associated with thicker tumors (P < .0001); this association was stronger in Hispanics. The RR of thicker tumors versus thinner tumors ( 2 mm) in the Low SES group versus the High SES group was 1.48 (95% confidence interval [CI], 1.37-1.61) for NHW men and 2.18 (95% CI, 1.73-2.74) for Hispanic men. Patients with lower SES had less of the superficial spreading melanoma subtype (especially among Hispanic men) and more of the nodular melanoma subtype. Leg/hip melanomas were associated with higher SES in NHW men but with lower SES in Hispanic men. CONCLUSIONS: The socioeconomic distribution of melanoma incidence and tumor thickness differed substantially between Hispanic and NHW Californians, particularly among men. Melanoma prevention efforts targeted to lower SES Hispanics and increased physician awareness of melanoma patterns among Hispanics are needed. Cancer 2011;117:152-61.

Disparities in the Presentation and Management of Cutaneous Melanoma That Required Admission

“…While Blacks and Hispanics were more likely to present with extremities melanomas and to experience a longer LOS and a higher cost. The observed higher prevalence of extremities melanoma in minorities is congruent with the established higher incidence of peripheral and acral melanoma in Black and Hispanics [13, 30, 33, 36]. In the multivariate model, there was no significant disparity in nodal metastasis among the different racial groups.…”

“…The socioeconomic status association with melanoma has been explored frequently with an effort to explain the racial disparities in melanoma outcomes. Most studies agree that melanoma risk is higher in population of high socioeconomic status, while a worse prognosis is more relevant in populations of low socioeconomic status [5, 11, 16, 29, 33]. There is some evidence that the differences in patient outcomes are associated with the type of health care delivery system in which they are enrolled [14, 15, 35].…”

Late diagnosis of nodular melanoma of the foot in a 74-year-old Brazilian man

“…R ecently, malignant melanoma (MM) has become a subject of major interest due to an increasing incidence and high morbidity and mortality rates [1][2][3][4][5][6] . Although this tumor represents only 4-5% of the skin cancers, it is the main cause of death related to skin malignancies, due to late diagnosis and high potential of distant metastases.…”

“…Although this tumor represents only 4-5% of the skin cancers, it is the main cause of death related to skin malignancies, due to late diagnosis and high potential of distant metastases. Foot and nail are uncommon sites (3-15%), with poor prognosis and high lethality [1][2][3][4][5][6] . Worth of note, a study of 4,607 Hispanic Californians with MM showed thicker tumors, in a late stage at diagnosis, with metastases and poor outcomes 4 .…”

“…Foot and nail are uncommon sites (3-15%), with poor prognosis and high lethality [1][2][3][4][5][6] . Worth of note, a study of 4,607 Hispanic Californians with MM showed thicker tumors, in a late stage at diagnosis, with metastases and poor outcomes 4 . In addition to the pattern of sun exposure, ethnic and genetic factors may play a role on the development of MM in population groups.…”