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AAD 2024: Melanoma Subtype–Specific Outcomes in Black vs White Patients

By: Julia Fiederlein Cipriano, MS
Posted: Monday, March 18, 2024

Gyorgy Paragh MD, PhD, of Roswell Park Comprehensive Cancer Center, Buffalo, New York, and colleagues conducted an analysis to determine whether different melanoma subtypes may contribute to disparities in outcomes among Black vs White patients. Their findings were presented as a poster during the 2024 American Academy of Dermatology Association (AAD) Annual Meeting (Poster 52133).

“Despite the prevailing belief that elevated melanoma mortality is solely attributed to delayed diagnosis, our findings show that, independent of disease severity at diagnosis for acral lentiginous melanoma, there is a considerably higher melanoma mortality rate in Black patients,” the investigators commented. “A better understanding of the root causes of racial disparity in early acral lentiginous melanoma will be critical to improving outcomes.”

The investigators used the Surveillance, Epidemiology, and End Results (SEER) database to identify patients with superficial spreading melanoma, nodular melanoma, and acral lentiginous melanoma. Based on a chi-square test, there was a significant difference in the stage at diagnosis between Black and White patients, with more Black patients being diagnosed with advanced superficial spreading and nodular melanomas (P < .0001). Those with acral lentiginous melanoma demonstrated no such racial disparity (P = .1031).  

Kaplan-Meier survival estimates revealed a significantly higher risk of melanoma-specific mortality in Black vs White patients across all melanoma subtypes. Black patients with acral lentiginous melanoma experienced a significantly higher risk of mortality (hazard ratio [HR] = 2.04), which was considered to be independent of clinicopathologic and socioeconomic variables, based on a multivariable Cox proportional hazard model. However, this did not appear to hold true for those with superficial spreading melanoma (HR = 0.95) or nodular melanoma (HR = 1.15). Of note, even when acral lentiginous melanoma was diagnosed at stage I, Black vs White patients had higher mortality rates (P < .0001), the investigators reported.

Disclosure: No information regarding conflicts of interest was provided.

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