Melanoma Among Non-Hispanic Black Americans

MaryBeth B. Culp, MPH; Natasha Buchanan Lunsford, PhD

Disclosures

Prev Chronic Dis. 2019;16(6):e79 

In This Article

Abstract and Introduction

Abstract

Introduction: Few studies have examined melanoma incidence and survival rates among non-Hispanic black populations because melanoma risk is lower among this group than among non-Hispanic white populations. However, non-Hispanic black people are often diagnosed with melanoma at later stages, and the predominant histologic types of melanomas that occur in non-Hispanic black people have poorer survival rates than the most common types among non-Hispanic white people.

Methods: We used the US Cancer Statistics 2001–2015 Public Use Research Database to examine melanoma incidence and 5-year survival among non-Hispanic black US populations.

Results: From 2011 through 2015, the overall incidence of melanoma among non-Hispanic black people was 1.0 per 100,000, and incidence increased with age. Although 63.8% of melanomas in non-Hispanic black people were of unspecified histology, the most commonly diagnosed defined histologic type was acral lentiginous melanoma (16.7%). From 2001 through 2014, the relative 5-year melanoma survival rate among non-Hispanic black people was 66.2%.

Conclusion: Although incidence of melanoma is relatively rare among non-Hispanic black populations, survival rates lag behind rates for non-Hispanic white populations. Improved public education is needed about incidence of acral lentiginous melanoma among non-Hispanic black people along with increased awareness among health care providers.

Introduction

Melanoma is one of the most common cancers in the United States, and incidence is increasing.[1] Most melanomas are thought to be caused by a combination of exposure to ultraviolet radiation and characteristics of sun-sensitive skin.[2] People with fair skin are generally at highest risk of melanoma; thus, recent research focused primarily on white and Hispanic populations.[3] However, few studies of melanoma were conducted among non-Hispanic black populations.[4] One of these studies found that ultraviolet radiation is associated with skin cancer risk among black men.[5]

Skin type or complexion is a key risk factor for skin cancer.[6] Melanin, which is produced in the skin, gives skin, hair, and eyes their color and protects the deep layers of skin cells from ultraviolet radiation damage.[6] Skin that produces more melanin is naturally darker and provides more sun protection from ultraviolet radiation than light skin, which produces less melanin.[6] Although exposure to ultraviolet radiation can cause DNA damage to all types of skin, some melanoma histology types are not attributable to exposure.[6,7] Although black men and women in the United States are at lower risk of melanoma than white men and women, they often have melanoma diagnosed at a later stage and have poorer survival as a result.[4,8] Furthermore, a range of skin complexions among non-Hispanic black people leads to variable risk from ultraviolet radiation exposure.[4]

Previous analyses found that melanoma histologic type and the body site where it occurs differ by race.[4,9] Acral lentiginous melanoma (ALM), which typically presents on the palms of hands, soles of feet, or nail beds, is associated with poor survival rates, and a greater proportion of melanomas diagnosed among non-Hispanic black people are ALM than are melanomas diagnosed among non-Hispanic whites.[10,11] We examined melanoma incidence and survival among non-Hispanic black populations in the United States by age, stage at diagnosis, anatomic site, and histology.

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