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Soo Park, MD
Soo Park, MD
Posted: Monday, May 19, 2025
A recent analysis of Merkel cell carcinoma (MCC) cases from 2016 to 2020 revealed significant disparities in diagnosis, treatment, and survival outcomes between patients of different socioeconomic status. David Reid, MD, and colleagues at Rush University Medical Center, Chicago, also found that patients with lower income and education levels were diagnosed with MCC at younger ages. They presented their findings at the 2025 AACR Annual Meeting.
The retrospective analysis looked at about 9,700 patients diagnosed with MCC from the National Cancer Database, analyzing their socioeconomic status by scoring income and education in quartiles, with Q1 being the lowest and Q4 the highest. Patients in Q1 presented with MCC at an average age of 73.8 years, compared to 75.0 years in Q4. Additionally, patients in Q1 presented withadvanced-stage disease more frequently than those in Q4 (9.67% vs 7.79%, P < .01). Comorbidity burdens were also higher among Q1 patients, with 8.41% exhibiting elevated Charlson-Deyo scores vs 5.8% in Q4 (P < .001).
Treatment methods varied between quartiles as well. Individuals in Q1 were more frequently treated with local tumor excision (14.39%), while patients in Q4 were more likely to receive Mohs surgery (5.02%).
One-year survival for Q1 patients was 82.99% vs 85.81% for Q4 patients (P < .001). At 3 years, survival was 61.18% in Q1 and 68.49% in Q4; 5-year survival rates were 45.99% and 55.09%, respectively (P < .001)—almost a 10% difference.
These findings underscore the impact of socioeconomic factors on diagnosis, survival, and comorbidity rates in patients with MCC, and highlight the reduced access to specialized surgical care patients from lower socioeconomic backgrounds face. The study also reveals the continued need for the evaluation of how social determinants of health impact cancer care delivery.
Disclosures: The study authors reported no conflicts of interest.
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