The diagnosis of melanoma is delayed in Hispanic and black patients, compared with whites, and thus the mortality burden is disproportionately high in these minority populations, according to a database analysis.
“The results of our study should motivate the expansion of melanoma awareness and screening campaigns to the minority communities, which can ultimately alleviate the disparities in melanoma outcome,” said Dr. Shasa Hu of Sylvester Comprehensive Cancer Center at the University of Miami and associates.
“Research and public education efforts have focused on melanoma prevention in white populations because of their higher risk of developing melanoma.” These campaigns to improve awareness are likely the reason that survival among whites has risen from 68% in the early 1970s to 92% in recent years, they noted.
To assess long-term trends in other ethnic groups, Dr. Hu and her colleagues analyzed data from the Florida Cancer Data System (FCDS), a database that includes information dating back to 1981 on a relatively large Hispanic population. In comparison, the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) database did not classify data according to the “Hispanic” designation until the late 1990s, they said.
Between 1990 and 2004, 41,072 melanoma cases with known patient ethnicity and disease stage were reported to the FCDS in three mutually exclusive categories: 39,670 cases among whites, 1,148 among white Hispanics, and 254 among black non-Hispanics.
Despite the lower incidence of melanoma among Hispanic and black patients, both minority groups were much more likely to have a delayed diagnosis than were whites. A total of 26% of black patients presented with either regional- or distant-stage melanoma, as did 18% of Hispanic patients. In contrast, only 12% of white patients presented with such advanced melanoma, the investigators said (Arch. Derm. 2009;145:1369–74).
Melanoma diagnosis improved very little over the 15-year study period among Hispanics and did not improve at all among blacks, but it improved significantly among whites.
“These results clearly suggest that public education and screening efforts have successfully reduced the burden of late-stage melanomas in white non-Hispanics but have not reached other populations who already have disproportionately greater burden from late-stage melanoma,” Dr. Hu and her associates said.
No financial conflicts of interest were reported.