Disparities in the Presentation and Management of Cutaneous Melanoma That Required Admission

Abstract

Objective: In this study, we aimed to examine the association of demographic and socioeconomic factors with cutaneous melanoma that required admission. Methods: A cross-sectional study utilizing the Nationwide Inpatient Sample database, 2003–2009, was merged with County Health Rankings Data. Results: A total of 2,765 discharge ­records were included. Men were more likely to have melanoma in the head, neck, and trunk regions (p < 0.001), while extremities melanoma was more common in women (p < 0.001). Males had a higher risk of lymph node metastasis on presentation (OR 1.54, 95% CI [1.27–1.89]). Blacks and Hispanics were more likely to present with extremities melanoma. Patients with low annual income were more likely to be treated by low-volume surgeons and in hospitals located in high-risk communities (p < 0.05 each). Patients with Medicaid coverage were twice as likely to present with distant metastasis and were more likely to be managed by low-volume surgeons (p < 0.05 each). Conclusions: The presentation and outcomes of cutaneous melanoma have a distinct pattern of distribution based on patients’ characteristics.

Disparities in Survival Outcomes among Racial/Ethnic Minorities with Head and Neck Squamous Cell Cancer in the United States

“…As in previous reports [ 12 , 13 , 14 , 15 ], we identified significant disparities in socioeconomic and health insurance coverage among Black HNSCC patients. Similarly, a SEER database analysis from Taylor et al, showed poorer outcomes in Black patients and demonstrated that socioeconomic status and health insurance were associated with head and neck cancer-specific survival and stage at presentation [ 16 ].…”

Geographic and demographic features of neuroendocrine tumors in the United States of America: A population‐based study

“…11 In a recently published study on patients with melanoma in the Nationwide Inpatient Sample database, people with a low income and Medicaid coverage were more likely to have worse outcomes. 18 In the field of NETs, black patients with pancreatic NETs had worse survival because of a more advanced stage at presentation and relatively limited access to surgery. 19 However, recent evidence indicates that the racial disparities are going down, and the differences in economic status, insurance coverage, and ease of health care access are becoming more prominent drivers in determining the outcomes of patients with cancer.…”

Association of Sociodemographic Factors With Immunotherapy Receipt for Metastatic Melanoma in the US

“…10,11 Combination therapy with nivolumab and ipilimumab also showed improved overall survival, [12][13][14] leading to approval of the combination in the first-line setting. 11,15 Despite the improvement in outcomes with ICIs for metastatic melanoma, previous studies 16,17 have found that sociodemographic health disparities are associated with limited access to effective therapies for melanoma, including immunotherapy. Underinsurance may be associated with delays in surgery and treatment at low-volume centers.…”

“…Despite the improvement in outcomes with ICIs for metastatic melanoma, previous studies have found that sociodemographic health disparities are associated with limited access to effective therapies for melanoma, including immunotherapy. Underinsurance may be associated with delays in surgery and treatment at low-volume centers.…”