Association Between Area Deprivation Index and Melanoma Stage at Presentation

Area of Science:

• Dermatology
• Public Health
• Health Disparities

Background:

• Late-stage melanoma diagnosis correlates with higher mortality rates.
• Factors such as healthcare access, socioeconomic status, and neighborhood characteristics influence melanoma stage at diagnosis.
• The Area Deprivation Index (ADI) is a key metric for assessing neighborhood disadvantage.

Purpose of the Study:

• To investigate the association between neighborhood disadvantage, quantified by the ADI, and the likelihood of a late-stage melanoma diagnosis.
• To understand how neighborhood-level factors contribute to disparities in melanoma presentation.
• To identify specific populations at higher risk for late-stage melanoma.

Main Methods:

• A cross-sectional analysis was performed on a retrospective cohort of 941 melanoma patients diagnosed between 2010 and 2019.
• Patient residential addresses were geocoded and linked to ADI and rurality data.
• Multivariable logistic regression models, with robust standard errors clustered at the census tract level, were employed to analyze associations with melanoma stage at diagnosis, adjusting for covariates like race, ethnicity, age, gender, and insurance status.

Main Results:

• Nearly half (46%) of the 941 patients were diagnosed with late-stage melanoma.
• Patients diagnosed with late-stage melanoma had a significantly higher mean ADI compared to those diagnosed with early-stage melanoma (5.4 vs. 3.3, p < 0.001).
• After adjusting for ADI, observed racial disparities in melanoma staging were attenuated, indicating ADI's significant role in these disparities.

Conclusions:

• Neighborhood disadvantage, as indicated by higher ADI scores, is a significant predictor of later-stage melanoma diagnosis.
• The findings underscore the role of neighborhood disadvantage in exacerbating racial and socioeconomic disparities in melanoma.
• Targeted public health initiatives and educational interventions are crucial for reducing late-stage melanoma diagnoses among disadvantaged and vulnerable populations.