Socioeconomic Factors in the Diagnosis and Treatment of Malignant Melanoma in Hispanic vs. Non-Hispanic Patients: A National Cancer Database (NCDB) Study
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Keywords
Melanoma, Social Determinants of Health, Socioeconomic Disparities, Skin Cancer, National Cancer Database (NCDB)
Abstract
Background: The incidence of melanoma is rapidly increasing in the United States. There is a paucity of research of how melanoma affects the Hispanic population, the quickest growing population.
Objective: To identify and understand how socioeconomic factors affect a Hispanic patients health outcome and treatment of malignant melanoma with comparisons to white, non-Hispanic patients (WNH).
Methods: A retrospective study utilizing the National Cancer Database (NCDB) was completed investigating Hispanic patients (n=2282) and WNH patients (n=190,469) with Stage I-IV malignant melanoma. Outcome and socioeconomic variables were identified and compared across groups. Data was analyzed with SPSS and SAS Statistical Software; Kaplan-Meier survival curves and Cox Proportional Hazard Regression Models were computed.
Results: Hispanic patients have 2.50 higher odds being diagnosed with Stage 4 vs. Stage 1 when compared to WNH patients (95% CI 2.20-2.86, p<0.001). Differences in insurance status, income, education, facility type, facility location, urban/rural, Charlson-Deyo score, and stage are all statistically significant for WNH compared to Hispanic patients (p<0.05).
Conclusions: In addition to various socioeconomic disparities, Hispanic patients are more likely than WNH to have melanoma diagnosed at higher stages and subtypes with worse prognosis. Clinicians need to provide skin cancer education and prevention and mobilize resources to serve this diverse population.
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