J Am Acad Dermatol. 2020 Aug 27:S0190-9622(20)32494-4. doi: 10.1016/j.jaad.2020.08.097. Online ahead of print.
BACKGROUND: Although the majority of cutaneous melanoma patients are non-Hispanic white (NHW), minorities consistently suffer worse melanoma specific survival (MSS). Much of the literature comes from analyses of registries from the 1990s and 2000s.
OBJECTIVE: 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 (SEER) 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 three time-periods: <2000, 2000-2009, and ≥2010. NHW was the reference group for all analyses.
RESULTS: Racial disparity worsened from <2000 to ≥2010 for Hispanic (P<0.001), NHB (P=0.024), and NHAPI (P<0.001) patients. Across all minority groups, patients with localized disease suffered increasing disparity (P=0.010 for Hispanic, P<0.001 for NHB, P=0.023 for NHAPI, and P=0.042 for NHAIAN). Among those with regional and distant disease, Hispanic patients were the only minority to experience worsening disparity (P=0.001 and P=0.019, respectively).
LIMITATIONS: Lack of immunotherapy and targeted treatment information CONCLUSIONS: Racial disparity in MSS is worsening. Improving post-diagnosis management for minorities with localized disease is imperative to mitigate disparity and improve survival.