The Odds of Stage IV Melanoma Diagnoses Based on Socioeconomic Factors. Issue 4 (July 2019)

• Record Type: Journal Article
• Authors: Dick, Mary; Aurit, Sarah; Silberstein, Peter
• Is Part Of: Journal of cutaneous medicine and surgery. Volume 23:Issue 4(2019)
• Page Start: 421
• Page End: 427
• Publication Date: 2019-07
• Subjects: cancer -- melanoma -- NCDB -- socioeconomic; Dermatology -- Periodicals; Skin -- Diseases -- Treatment -- Periodicals; Skin -- Surgery -- Periodicals; Dermatology -- Canada -- Periodicals; Skin -- Diseases -- Treatment -- Canada -- Periodicals; Skin -- Surgery -- Canada -- Periodicals; 616.5005
• DOI: 10.1177/1203475419847955
• Languages: English
• ISSNs: 1203-4754

Abstract

Background: When diagnosed at stage 0-I, melanoma has a 5-year survival rate of 92% to 100% in comparison with stage IV, which has a 5-year survival rate of 15% to 20%. Objective: The objective of this article is to identify what socioeconomic and demographic factors were associated with increased odds in receiving a delayed melanoma diagnosis. Methods: This study analyzed the odds of 108, 628 patients from the National Cancer Database who were diagnosed between 2004 and 2012 with American Joint Committee on Cancer stage 0-I and stage IV based on race, sex, insurance type, income, facility type, and education. Results: We identified significantly ( P < .05) increased odds of stage IV primary melanoma diagnosis in those who had nonprivate insurance, including Medicare (odds ratio [OR] = 1.31, 95% confidence interval [CI]: 1.19-1.45), other government insurance (OR = 2.19, 95% CI: 1.61-2.98), Medicaid (OR = 6.97, 95% CI: 5.98-8.13), or no insurance (OR = 5.10, 95% CI: 4.41-5.91). Increased odds of late-stage melanoma were also associated with male sex (OR = 1.46, 95% CI: 1.36-1.57), race and ethnicity other than non-Hispanic white such as Hispanic whites (OR = 1.49, 95% CI: 1.15-1.92) or African Americans (OR=4.81, 95% CI: 3.75-6.18), and who had decreased education (OR = 1.19, 95% CI: 1.09-1.30). There was not a significant increase in odds of late-stage melanoma in patients from areas with the lowest levels of income compared with areas of highest income. Conclusions: Certain socioeconomic and demographic factors are associated with odds of a later-stage melanoma diagnosis.