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Racial differences in time to treatment for melanoma
Raghav Tripathi1, Laura K Archibald2, Rishabh S Mazmudar1
1Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio.
Journal of the American Academy of Dermatology
|April 12, 2020
Summary
Black patients experience significantly longer times to melanoma treatment compared to white patients, contributing to survival disparities. Addressing these delays is crucial for improving outcomes in black melanoma patients.
Area of Science:
- Oncology
- Health Disparities Research
- Clinical Outcomes Analysis
Background:
- Longer time from diagnosis to definitive surgery (TTDS) is linked to increased melanoma-specific mortality.
- Black patients are diagnosed with later-stage melanoma and have poorer survival rates than non-Hispanic white patients.
- The relationship between race and TTDS was previously unknown.
Purpose of the Study:
- To investigate potential racial disparities in the time to melanoma treatment.
- To analyze the association between race and time to definitive surgery for melanoma patients.
Main Methods:
- Retrospective analysis of the National Cancer Database from 2004 to 2015.
- Utilized multivariable logistic regression to assess the link between race and TTDS.
- Controlled for sociodemographic and disease-specific characteristics in the analysis.
Main Results:
- Black patients (0.52%) had significantly longer TTDS for stages I-III melanoma and for immunotherapy initiation.
- After controlling for other factors, black patients had 2-5 times higher odds of delayed treatment (41-90+ days).
- Patients with Medicaid experienced the longest TTDS, while those with private insurance had the shortest delays.
Conclusions:
- Racial disparities in TTDS exist for melanoma patients.
- Targeted interventions are necessary to reduce treatment delays for black patients.
- Reducing TTDS is essential for mitigating racial disparities in melanoma survival outcomes.
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