Race, Socioeconomic Status Tied to Melanoma Survival

By Megan Brooks

February 22, 2022

NEW YORK (Reuters Health) - Race and socioeconomic status are associated with survival from acral lentiginous melanoma (ALM), according to a retrospective study.

ALM is a type of melanoma that appears on the palms of the hands, the soles of the feet, or under the nails. Though relatively uncommon in the general population, ALM accounts for most melanomas in people with darker skin.

Among 2,245 patients with a first diagnosis of ALM, five-year disease-specific survival overall was 77.8%.

Further analysis showed that patients in the lowest and second-to-lowest socioeconomic groups had 1.33 (95% CI, 0.90 to 1.96) and 1.42 (95% CI, 1.03 to 1.97) times the risk of dying from ALM, respectively, compared with peers in the highest socioeconomic group.

Hispanic white and Black patients had 1.48 (95% CI, 1.10 to 1.99) and 1.25 (95% CI, 0.88 to 1.79) times the risk of death, respectively, compared to non-Hispanic white patients. Five-year survival was 69.7% for Hispanic whites, 70.0% for Black patients and 80.4% for non-Hispanic white patients.

Stage-IV disease was roughly three times more common among those in the lowest socioeconomic category (4.6%) than those in the highest (1.5%).

"Understanding factors driving survival disparities related to socioeconomic status and race may improve ALM outcomes," researchers write in the Journal of the American Academy of Dermatology.

"While it is possible the biology of ALM may be different in subgroups of patients, we also have to consider that environmental factors may influence survival," lead author Dr. Amit Garg of the Feinstein Institutes for Medical Research, in Manhasset, New York, told Reuters Health by email.

"Survival among patients with ALM having lower socioeconomic status may be related to poor patient awareness of melanoma including risk and its clinical features on the skin, barriers to access in care, as well as suboptimal screening efforts in the medical community, all of which may result in delayed detection," Dr. Garg said.

"Persons of color are also at risk for melanoma. Increasing awareness around ALM and eliminating barriers to care for concerning lesions may result in earlier detection," Dr. Garg added.

In a statement, Dr. Kevin Tracey, president and CEO of the Feinstein Institutes, said, "Social determinants of health affect a wide range of outcomes. Dr. Garg's findings in acral lentiginous melanoma provide important awareness, a necessary step to begin addressing this disparity."

SOURCE: https://bit.ly/3rWF8y5 Journal of the American Academy of Dermatology, online January 29, 2022.

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