Disparity Found in Melanoma Diagnosis
Melanoma is among the top 10 new cancer diagnoses for both American men and women. Did you know that blacks and Hispanics can develop melanoma?
Robert Kirsner, MD, PhD and colleagues published a study in the December 2009 Archives of Dermatology reporting the diagnosis of melanoma in blacks and Hispanics is often made at a more advanced stage than it is for whites.
Research and public education largely focuses on melanoma prevention in white populations because of their risk of developing melanoma is much higher than any other race. Early detection has led to improved survival among whites from 68% in the early 1970s to 92% in recent years. Such advances have not occurred in other racial and ethnic groups in the United States.
The researchers analyzed information in the Florida Cancer Data System, a statewide, population-based cancer registry, looking at three 5-year periods -- from 1990 to 1994, 1995 to 1999, and 2000 to 2004.
From 1990 to 2004, there were 41,072 cases of melanoma diagnosed. Of these, 39,670 were in whites, 1,148 in Hispanics and 254 in blacks. During that period, Hispanics and blacks were found to have metastatic disease more frequently than whites (18% of Hispanics, 26% of blacks, 12% of whites).
"There is a lack of knowledge about blacks and Hispanics at risk, so these populations don't use primary prevention, like being 'sun smart,' " Dr. Kirsner said. Also, suspicious lesions may be ignored by patients and physicians, he added, with physicians thinking, "The likelihood of this being anything bad is remote."
He urged clinicians to be alert to possible melanomas in unusual locations, such as on the bottom of feet or palms of hands of minority patients.
It is important for everyone to remember that all people are candidates for melanoma, even people of color. All should use preventive behavior. All should seek care when suspicious moles or skin lesions are noticed.
Disparity in Melanoma: A Trend Analysis of Melanoma Incidence and Stage at Diagnosis Among Whites, Hispanics, and Blacks in Florida; Arch Dermatol. 2009;145(12):1369-1374; Shasa Hu, MD; Yisrael Parmet, PhD; Glenn Allen, MPH; Dorothy F. Parker, MHS; Fangchao Ma, MD, PhD; Panta Rouhani, PhD, MPH; Robert S. Kirsner, MD, PhD