RESEARCH led by the Mayo Clinic Comprehensive Cancer Center, Rochester, Minnesota, USA has found significant disparities in melanoma presentations and outcomes between non-Hispanic Black (NHB) and non-Hispanic White (NHW) patients, emphasising the importance of targeted early detection and treatment strategies.
Data used for melanoma guidelines mainly come from NHW patients, or from a very broad range of patients. This focus has inadvertently overlooked the unique presentation and progression patterns of melanoma in Black populations, who might experience late diagnosis and subsequently, worse outcomes. In a study conducted at the Mayo Clinic Comprehensive Cancer Center, researchers identified features of melanoma in NHB patients, and compared the data from the two groups to inform strategies for earlier detection and treatment.
The study collected Surveillance, Epidemiology, and End Results (SEER) data between 2004–2019, and identified patients with non-metastatic melanoma with known Trade NAFTA status (a special non-immigrant classification of foreign nationals in the USA), age, sex, and race. The study encompassed a total of 492,597 patients with melanoma, of which 1,499 (0.3%) were identified as NHB. The NHB cohort presented at younger ages, and had a higher percentage of females compared to their NHW counterparts.
Results showed striking differences in disease presentation between NHB and NHW patients. NHB patients presented with a higher frequency of lower extremity melanoma (52% versus 15%; P<0.0001), and were diagnosed at more advanced stages compared to NHW patients (19% Stage III versus 6% Stage III; P<0.0001). NHB males with melanoma were also older, and more often node-positive, compared to NHB females. Moreover, data showed that between Black males and females, the rate for 5-year Stage III cancer-specific survival was 42% versus 71%, indicating that Black females have better survival rates compared to Black males.
This study highlights significant disparities in melanoma presentation and outcomes among NHB patients, which underscores the need for new approaches to screening and treatment. Further research is needed to fully investigate the social risk factors and biological components in melanoma. It should aim to include a broader spectrum of racial groups, and integrate more comprehensive socio-economic data to better understand the underlying melanoma outcomes.
Reference
Steadman JA et.al. Distinct presentation of melanoma in Black patients may inform strategies to improve outcomes. J Surg Oncol. 2024;129(6): 1041-1050.
