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Elad VM, Anton T, Ganios NC, Rebecca VW. Undereducation is afoot: Assessing the lack of acral lentiginous melanoma educational materials for skin of color. Pigment Cell Melanoma Res 2023; 36:431-438. [PMID: 37171057 DOI: 10.1111/pcmr.13090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/20/2023] [Accepted: 04/05/2023] [Indexed: 05/13/2023]
Abstract
Acral lentiginous melanoma (ALM) is a subtype of cutaneous melanoma notorious for poor outcomes that disproportionately affect individuals with skin of color (e.g., African-, Hispanic-, Asian-descent) when compared to mortality rates among non-Hispanic White populations. There are several societal factors that contribute to racial disparities in ALM, including a lack of representative educational material in the context of patient education and medical instruction. This gap in representative information for the US population includes risk of disease, patterns of incidence, and differences in disease presentation in skin of color. The atypical presentation of ALM on acral volar skin sites makes early detection challenging and necessitates an increased index of suspicion on the part of physicians and patients alike. Studies underscoring the importance of early detection in reducing mortality risk make the availability of adequate representative educational materials indispensable.
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Affiliation(s)
- Vissy M Elad
- College of Medicine, Northeast Ohio Medical University, Ohio, Rootstown, USA
| | - Trevena Anton
- College of Medicine, Northeast Ohio Medical University, Ohio, Rootstown, USA
| | - Natalie C Ganios
- College of Medicine, Northeast Ohio Medical University, Ohio, Rootstown, USA
| | - Vito W Rebecca
- Department of Biochemistry and Molecular Biology, Johns Hopkins University Bloomberg School of Public Health, Maryland, Baltimore, USA
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Wong CK, Dite GS, Spaeth E, Murphy NM, Allman R. Melanoma risk prediction based on a polygenic risk score and clinical risk factors. Melanoma Res 2023; 33:293-299. [PMID: 37096571 PMCID: PMC10309112 DOI: 10.1097/cmr.0000000000000896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 03/30/2023] [Indexed: 04/26/2023]
Abstract
Melanoma is one of the most commonly diagnosed cancers in the Western world: third in Australia, fifth in the USA and sixth in the European Union. Predicting an individual's personal risk of developing melanoma may aid them in undertaking effective risk reduction measures. The objective of this study was to use the UK Biobank to predict the 10-year risk of melanoma using a newly developed polygenic risk score (PRS) and an existing clinical risk model. We developed the PRS using a matched case-control training dataset ( N = 16 434) in which age and sex were controlled by design. The combined risk score was developed using a cohort development dataset ( N = 54 799) and its performance was tested using a cohort testing dataset ( N = 54 798). Our PRS comprises 68 single-nucleotide polymorphisms and had an area under the receiver operating characteristic curve of 0.639 [95% confidence interval (CI) = 0.618-0.661]. In the cohort testing data, the hazard ratio per SD of the combined risk score was 1.332 (95% CI = 1.263-1.406). Harrell's C-index was 0.685 (95% CI = 0.654-0.715). Overall, the standardized incidence ratio was 1.193 (95% CI = 1.067-1.335). By combining a PRS and a clinical risk score, we have developed a risk prediction model that performs well in terms of discrimination and calibration. At an individual level, information on the 10-year risk of melanoma can motivate people to take risk-reduction action. At the population level, risk stratification can allow more effective population-level screening strategies to be implemented.
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Affiliation(s)
| | | | - Erika Spaeth
- Phenogen Sciences Inc., Charlotte, North Carolina, USA
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3
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Abstract
Skin cancer is often associated with greater morbidity and mortality in skin of color patients because most medical literature and research on skin cancer to date has been predominantly focused on lighter skin types. It is crucial that dermatologic providers be able to recognize different presentations of skin cancer in skin of color patients to optimize the early detection of these tumors and ensure equitable outcomes. This article details the epidemiology, risk factors, clinical features, and disparities in the treatment of melanoma, squamous cell carcinoma, basal cell carcinoma, and mycosis fungoides subtype of cutaneous T-cell lymphoma in skin of color patients.
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Affiliation(s)
- Ananya Munjal
- University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Nkanyezi Ferguson
- University of Missouri Department of Dermatology, Missouri, Columbia, MO, USA.
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Brănișteanu DE, Porumb-Andrese E, Stărică A, Munteanu AC, Toader MP, Zemba M, Porumb V, Cozmin M, Moraru AD, Nicolescu AC, Brănișteanu DC. Differences and Similarities in Epidemiology and Risk Factors for Cutaneous and Uveal Melanoma. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050943. [PMID: 37241175 DOI: 10.3390/medicina59050943] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 04/17/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023]
Abstract
Both cutaneous melanoma (CM) and uveal melanoma (UM) represent important causes of morbidity and mortality. In this review, we evaluate the available knowledge on the differences and similarities between cutaneous melanoma and uveal melanoma, focusing on the epidemiological aspects and risk factors. Uveal melanoma is a rare condition but is the most prevalent primary intra-ocular malignant tumor in adults. Cutaneous melanoma, on the other hand, is significantly more common. While the frequency of cutaneous melanoma has increased in the last decades worldwide, the incidence of uveal melanoma has remained stable. Although both tumors arise from melanocytes, they are very distinct entities biologically, with complex and varied etiologies. Both conditions are encountered more frequently by individuals with a fair phenotype. ultraviolet-radiation is an important, well-documented risk factor for the development of CM, but has shown not to be of specific risk in UM. Although cutaneous and ocular melanomas seem to be inherited independently, there are reported cases of concomitant primary tumors in the same patient.
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Affiliation(s)
- Daciana Elena Brănișteanu
- Dermatology Department, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
- Railway Clinical Hospital, 700506 Iasi, Romania
| | - Elena Porumb-Andrese
- Dermatology Department, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
- Railway Clinical Hospital, 700506 Iasi, Romania
| | - Alexandra Stărică
- Dermatology Department, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
- Railway Clinical Hospital, 700506 Iasi, Romania
| | - Anca Catalina Munteanu
- Dermatology Department, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
- Railway Clinical Hospital, 700506 Iasi, Romania
| | | | - Mihail Zemba
- Ophthalmology Department, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Vlad Porumb
- Department Surgery, 'Grigore T. Popa' University of Medicine and Pharmacy, 700111 Iasi, Romania
| | - Mihai Cozmin
- Clinical Department, Apollonia University of Iasi, 700511 Iasi, Romania
| | - Andreea Dana Moraru
- Ophthalmology Department, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Alin Codruț Nicolescu
- Roma Medical Center for Diagnosis and Treatment, 011773 Bucharest, Romania
- "Agrippa Ionescu" Emergency Clinical Hospital, 011773 Bucharest, Romania
| | - Daniel Constantin Brănișteanu
- Railway Clinical Hospital, 700506 Iasi, Romania
- Ophthalmology Department, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
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Gazivoda VP, Koshenkov VP, Kangas-Dick AW, Greenbaum A, Davis C, Smith FO, Hilden PD, Berger AC. Factors Associated With Upstaging of Melanoma Thickness on Final Excision. J Surg Res 2023; 289:253-260. [PMID: 37150080 DOI: 10.1016/j.jss.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 02/19/2023] [Accepted: 04/04/2023] [Indexed: 05/09/2023]
Abstract
INTRODUCTION The incidence and risk factors associated with upstaging from initial biopsy to definitive excision in cutaneous melanoma have not been established. The aim of this study was to determine the incidence of tumor stage upstaging and associated risk factors using the National Cancer Database. METHODS A retrospective study of the National Cancer Database between 2012 and 2016 was performed. The cohort of patients undergoing excision of melanoma with available data comprised 133,592 patients. Differences in characteristics for upstaging were determined using Wilcox rank-sum, chi-square, or Fisher's exact tests. Multivariable analysis was performed using logistic regression to determine factors associated with upstaging. RESULTS Incidence of upstaging was 5.2%. Upstaged patients were older, male, of non-White race, and of lower education level (P < 0.001). Lesions of the head/neck and lower extremity had increased incidence of upstaging compared to the trunk (P < 0.001). Nodular and acral lentiginous melanoma was associated with higher incidence of upstaging compared to superficial spreading melanoma (P < 0.001). Patients with lymphovascular invasion had increased risk of upstaging (P < 0.001). CONCLUSIONS Upstaging of melanoma is infrequent but is significantly more prevalent in non-White patients and those with lower educational status. Provider and patient education should include the higher risk of upstaging in these groups and the possible need for further surgical intervention, such as re-excision of margins and sentinel lymph node biopsy.
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Affiliation(s)
- Victor P Gazivoda
- Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Vadim P Koshenkov
- Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Aaron W Kangas-Dick
- Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Alissa Greenbaum
- Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Catherine Davis
- Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Franz O Smith
- Division of Surgical Oncology, RWJ Barnabas Health, Livingston, New Jersey
| | - Patrick D Hilden
- Department of Biostatistics, RWJ Barnabas Health, Livingston, New Jersey
| | - Adam C Berger
- Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey.
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Gonzalez S, King AD, Moossavi M. Nodular melanoma in an African American Japanese male. Clin Case Rep 2023; 11:e7083. [PMID: 36937623 PMCID: PMC10017401 DOI: 10.1002/ccr3.7083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/28/2023] [Accepted: 02/26/2023] [Indexed: 03/18/2023] Open
Abstract
Nodular melanoma (NM) is the third most common subtype of melanoma among African Americans trailing behind acral lentiginous melanoma and superficial spreading melanoma. This case of NM in an African American Japanese male was selected due to the rare occurrence of NM in people of color.
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Affiliation(s)
- Sarah Gonzalez
- Wayne State University School of MedicineDetroitMichiganUSA
| | - Andrew D. King
- Wayne State University School of MedicineDetroitMichiganUSA
| | - Meena Moossavi
- Wayne State University School of MedicineDetroitMichiganUSA
- Department of Dermatology, John D. Dingell VA Medical CenterWayne State University School of MedicineDetroitMichiganUSA
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Zueger M, Nahod P, Marroquin NA, Szeto MD, Ajmal H, Martini O, Burnette C, Quinn AP, Furth G, Militello M, Dellavalle RP. Skin of Color Dermatology Representation in American College of Mohs Surgery Educational Cases on Instagram: Content Analysis. JMIR DERMATOLOGY 2023; 6:e44103. [PMID: 37632910 PMCID: PMC10335130 DOI: 10.2196/44103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/09/2022] [Accepted: 01/05/2023] [Indexed: 01/15/2023] Open
Affiliation(s)
- Morgan Zueger
- College of Osteopathic Medicine, Rocky Vista University, Greenwood Village, CO, United States
| | - Paige Nahod
- College of Osteopathic Medicine, Rocky Vista University, Greenwood Village, CO, United States
| | - Nathaniel A Marroquin
- College of Osteopathic Medicine, Rocky Vista University, Greenwood Village, CO, United States
| | - Mindy D Szeto
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Hamza Ajmal
- College of Osteopathic Medicine, Rocky Vista University, Greenwood Village, CO, United States
| | - Olnita Martini
- College of Osteopathic Medicine, Rocky Vista University, Greenwood Village, CO, United States
| | - Colin Burnette
- College of Osteopathic Medicine, Nova Southeastern University, Davie, FL, United States
| | - Alyssa P Quinn
- College of Osteopathic Medicine, Rocky Vista University, Greenwood Village, CO, United States
| | - Garrett Furth
- College of Osteopathic Medicine, Rocky Vista University, Greenwood Village, CO, United States
| | - Michelle Militello
- Department of Dermatology, HCA Florida Orange Park Hospital, Orange Park, FL, United States
| | - Robert P Dellavalle
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- Dermatology Service, US Department of Veterans Affairs, Rocky Mountain Regional VA Medical Center, Aurora, CO, United States
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8
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Etiologies of Melanoma Development and Prevention Measures: A Review of the Current Evidence. Cancers (Basel) 2021; 13:cancers13194914. [PMID: 34638397 PMCID: PMC8508267 DOI: 10.3390/cancers13194914] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 12/14/2022] Open
Abstract
Simple Summary Melanoma constitutes a major public health risk, with the rates of diagnosis increasing on a yearly basis. Monitoring for risk factors and preventing dangerous behaviors that increase melanoma risk, such as tanning, are important measures for melanoma prevention. Additionally, assessing the effectiveness of various methods to prevent sun exposure and sunburns—which can lead to melanoma—is important to help identify ways to reduce the development of melanoma. We summarize the recent evidence regarding the heritable and behavioral risks underlying melanoma, as well as the current methods used to reduce the risk of developing melanoma and to improve the diagnosis of this disease. Abstract (1) Melanoma is the most aggressive dermatologic malignancy, with an estimated 106,110 new cases to be diagnosed in 2021. The annual incidence rates continue to climb, which underscores the critical importance of improving the methods to prevent this disease. The interventions to assist with melanoma prevention vary and typically include measures such as UV avoidance and the use of protective clothing, sunscreen, and other chemopreventive agents. However, the evidence is mixed surrounding the use of these and other interventions. This review discusses the heritable etiologies underlying melanoma development before delving into the data surrounding the preventive methods highlighted above. (2) A comprehensive literature review was performed to identify the clinical trials, observational studies, and meta-analyses pertinent to melanoma prevention and incidence. Online resources were queried to identify epidemiologic and clinical trial information. (3) Evidence exists to support population-wide screening programs, the proper use of sunscreen, and community-targeted measures in the prevention of melanoma. Clinical evidence for the majority of the proposed preventive chemotherapeutics is presently minimal but continues to evolve. (4) Further study of these chemotherapeutics, as well as improvement of techniques in artificial intelligence and imaging techniques for melanoma screening, is warranted for continued improvement of melanoma prevention.
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Carter TM, Strassle PD, Ollila DW, Stitzenberg KB, Meyers MO, Maduekwe UN. Does acral lentiginous melanoma subtype account for differences in patterns of care in Black patients? Am J Surg 2021; 221:706-711. [PMID: 33461732 PMCID: PMC8376182 DOI: 10.1016/j.amjsurg.2020.12.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 12/11/2020] [Accepted: 12/21/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Melanoma-specific outcomes for Black patients are worse when compared to non-Hispanic white (NHW) patients. We sought to evaluate whether acral lentiginous melanoma, seen more commonly in Black patients, was associated with racial disparities in outcomes METHODS: The National Cancer Database was analyzed for major subtypes of stage I-IV melanoma diagnosed from 2004 to 2016. The association between Black race and (Siegel et al., Jan) 1 acral melanoma diagnosis and (Bradford et al., Apr) 2 receipt of major amputation for surgical management of melanoma was evaluated using multivariable logistic regression. RESULTS 251,864 patients were included (1453 Black). Black patients had increased odds of acral melanoma (odds ratio [OR] = 27.6, 95% CI]: 24.4, 31.2) compared to NHW patients. Black patients still had higher odds ratios of major amputation across all stages after adjusting for acral histology and other potential confounders CONCLUSIONS: Increased prevalence of acral melanoma in Black patients does not fully account for increased receipt of major amputation.
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Affiliation(s)
- Taylor M Carter
- Department of Surgery, University of North Carolina, Chapel Hill, NC, USA
| | - Paula D Strassle
- Department of Surgery, University of North Carolina, Chapel Hill, NC, USA
| | - David W Ollila
- Division of Surgical Oncology and Endocrine Surgery, Department of Surgery, University of North Carolina, Chapel Hill, NC, USA
| | - Karyn B Stitzenberg
- Division of Surgical Oncology and Endocrine Surgery, Department of Surgery, University of North Carolina, Chapel Hill, NC, USA
| | - Michael O Meyers
- Division of Surgical Oncology and Endocrine Surgery, Department of Surgery, University of North Carolina, Chapel Hill, NC, USA
| | - Ugwuji N Maduekwe
- Division of Surgical Oncology and Endocrine Surgery, Department of Surgery, University of North Carolina, Chapel Hill, NC, USA.
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Anaba EL. Comparative study of cutaneous melanoma and its associated issues between people of African decent and Caucasians. Dermatol Ther 2021; 34:e14790. [PMID: 33480165 DOI: 10.1111/dth.14790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 12/16/2020] [Accepted: 01/17/2021] [Indexed: 01/08/2023]
Abstract
Cutaneous melanoma is uncommon in people of African descent unlike their Caucasian counterparts. This rarity of cutaneous melanoma in people of African descent makes studies in this group difficult. In the few studies that are available, several differences exist in the incidence, disease severity, course of the disease, treatment modalities and survival rates between these two groups. Observed difference in cutaneous melanoma between people of African descent and Caucasians include; a higher incidence and better prognosis in Caucasians, a low awareness of melanoma, no definite risk factors, presentation with advanced disease, poor melanoma specific survival in people of African descent. Other differences are a better UV-induced DNA damage recovery, acral as opposed to truncal melanoma, female preponderance and lack of preventive measures in people of African descent.
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Affiliation(s)
- Ehiaghe L Anaba
- Department of Medicine, Lagos State University Teaching Hospital, Lagos, Nigeria
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Cortez JL, Vasquez J, Wei ML. The impact of demographics, socioeconomics, and health care access on melanoma outcomes. J Am Acad Dermatol 2020; 84:1677-1683. [PMID: 32783908 DOI: 10.1016/j.jaad.2020.07.125] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 07/25/2020] [Accepted: 07/29/2020] [Indexed: 12/13/2022]
Abstract
Disparities in melanoma care exist in the United States. Disparities in provider type, patient demographics, place of residence, insurance status, socioeconomic status, race/ethnicity, and age impact melanoma outcomes. Melanomas detected by dermatologists are thinner, at an earlier stage, and have better survival outcomes compared with detection by primary care providers or patients. Lower socioeconomic status, race/ethnicity, and place of residence are associated with decreased access to or use of dermatologists, or both, and more advanced melanomas at diagnosis. Additionally, uninsured and publicly insured individuals are more likely to present with late-stage melanomas, resulting in worse outcomes. This review provides a comprehensive overview of how structural and patient-level characteristics influence melanoma outcomes in order to inform clinical care and health care policy as it relates to addressing gaps in melanoma care.
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Affiliation(s)
- Jose L Cortez
- Department of Dermatology, University of California, San Francisco, California; Dermatology Service, San Francisco Veterans Affairs Medical Center, San Francisco, California
| | - Juan Vasquez
- Dermatology Service, San Francisco Veterans Affairs Medical Center, San Francisco, California
| | - Maria L Wei
- Department of Dermatology, University of California, San Francisco, California; Dermatology Service, San Francisco Veterans Affairs Medical Center, San Francisco, California; University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, California.
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12
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Mahendraraj K, Sidhu K, Lau CS, McRoy GJ, Chamberlain RS, Smith FO. Malignant Melanoma in African-Americans: A Population-Based Clinical Outcomes Study Involving 1106 African-American Patients from the Surveillance, Epidemiology, and End Result (SEER) Database (1988-2011). Medicine (Baltimore) 2017; 96:e6258. [PMID: 28403068 PMCID: PMC5403065 DOI: 10.1097/md.0000000000006258] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Malignant melanoma accounts for 75% of all skin cancer deaths and is potentially curable if identified early. Although melanoma is rare in African-Americans (AA), it is associated with a worse prognosis than in Caucasians. This study examines the demographic, pathologic, and clinical factors impacting AA melanoma outcomes.Data for 1106 AA and 212,721 Caucasian cutaneous melanoma patients were abstracted from the Surveillance, Epidemiology, and End Result (SEER) database (1988-2011). Data were grouped on the basis of histological subtypes: "Superficial Spreading" (SS), "Nodular" (NM), "Lentigo Maligna" (LM), "Acral Lentiginous" (AL), and "Not otherwise specified" (NOS).Cutaneous malignant melanoma occurs most commonly in the sixth and seventh decade of life. Caucasian patients presented most commonly with trunk melanomas (34.5%), while lower extremity melanomas were more common in AAs (56.1%), P < 0.001. AAs presented with deeper tumors, more advanced stage of disease, and higher rates of ulceration and lymph node positivity than Caucasians. Cancer-specific mortality was significantly higher, while 5-year cancer-specific survival was significantly lower among AAs for NM and AL subtypes. Multivariate analysis identified male gender, regional and distant stage, NM and AL subtypes as independently associated with increased mortality among both ethnic groups.AAs present most often with AL melanoma on the lower extremities, and with deeper and more advanced stage lesions. AAs have higher cancer-specific mortality for NM and LM than Caucasians. Melanoma education for AA patients and health care providers is needed to increase disease awareness, facilitate early detection, and promote access to effective treatment.
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Affiliation(s)
| | - Komal Sidhu
- Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ
| | - Christine S.M. Lau
- Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ
- Saint George's University School of Medicine, Grenada, West Indies
| | - Georgia J. McRoy
- Saint George's University School of Medicine, Grenada, West Indies
| | - Ronald S. Chamberlain
- Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ
- Saint George's University School of Medicine, Grenada, West Indies
- Department of Surgery, New Jersey Medical School, Rutgers University, Newark, NJ
- Department of Surgery, Banner MD Anderson Cancer Center, Gilbert, AZ
| | - Franz O. Smith
- Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ
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