Cited by 176Cutaneous Melanoma Detection and ManagementGlobal Cancer Incidence and ScreeningHealth disparities and outcomes

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Survival for Patients With Invasive Cutaneous Melanoma Among Ethnic Groups: The Effects of Socioeconomic Status and Treatment

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Zell, Jason A., Cinar, Pelin, Mobasher, Mehrdad, Ziogas, Argyrios, Meyskens, Frank L., Anton-Culver, Hoda·2008·Journal of Clinical Oncology

DOI 10.1200/jco.2007.12.3604

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Abstract

Purpose: Although uncommon, melanoma is associated with poor survival characteristics among African Americans and Hispanics compared with non-Hispanic whites (NHWs). Low socioeconomic status (SES) is also associated with poor survival among patients with melanoma, but it is not known whether this is because of SES itself or because of treatment disparities. We set out to determine this by using the large, population-based California Cancer Registry (CCR) database as a model. Patients and Methods: We conducted a case-only analysis of CCR data (1993 to 2003), including a descriptive analysis of relevant clinical variables and SES. The SES variable used has been derived from principle component analysis of census block-level CCR data that was linked to census data to address seven indicators of SES. Univariate analyses of overall survival (OS) were conducted using the Kaplan-Meier method. Multivariate survival analyses were performed using Cox proportional hazard ratios (HRs). Results: A total of 39,049 incident patient cases of cutaneous melanoma, including 36,694 in NHWs; 127 in African Americans; 1,996 in Hispanics; and 262 in Asian-Americans, were analyzed. Higher SES was associated with an early stage at presentation (P < .0001), with treatment with surgery (P = .0005), and with prolonged survival (P < .0001). After adjustments for age, sex, histology, American Joint Committee on Cancer stage, anatomic site, treatment, and SES, a statistically significant increased risk of death was observed for African Americans compared with NHWs (HR, 1.60; 95% CI, 1.17 to 2.18); no survival differences were noted for Asians or Hispanics compared with NHWs in the adjusted analysis. Conclusion: Low SES independently predicts poor outcome among patients with cutaneous melanoma. However, the poor OS observed for African American patients with melanoma is not explained by differences in treatment or SES.

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Authors: Zell, J. A., Cinar, P., Mobasher, M., Ziogas, A., Meyskens, F. L., & Anton-Culver, H.
Affiliations: University of California, Irvine (US)
From the Division of Hematology/Oncology, Department of Internal Medicine, Chao Family Comprehensive Cancer Center; the Department of Epidemiology, School of Medicine; and the Genetic Epidemiology Research Institute, University of California, Irvine; and the Divisions of Hematology and Oncology, Stanford University, Palo Alto, CA
ORCID: Zell, Jason A.
Cinar, Pelin
Ziogas, Argyrios
Meyskens, Frank L.
Venue: Journal of Clinical Oncology
Publisher: American Society of Clinical Oncology (ASCO)
Published: 2008-01-01
Volume: 26
Issue: 1
Pages: 66-75
ISSN: 0732-183X (ISSN-L)
1527-7755
DOI: 10.1200/jco.2007.12.3604
OpenAlex: W2118033225
Cited by: 176
References: 42
Citations by year: 2026: 4 · 2025: 6 · 2024: 10 · 2023: 9 · 2022: 16 · 2021: 9 · 2020: 5 · 2019: 3 · 2018: 8 · 2017: 12 · 2016: 9 · 2015: 10 · 2014: 10 · 2013: 6 · 2012: 10
FWCI: 5.38
Type: journal article
Language: en
Open access: green
escholarship.org
Locations: Journal of Clinical Oncology (publishedVersion)
PubMed (publishedVersion)
eScholarship (California Digital Library) (submittedVersion)
Funders: National Cancer Institute (P30CA062203)
Topics: Health Sciences › Medicine › Oncology › Cutaneous Melanoma Detection and Management
Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
Social Sciences › Health › Health disparities and outcomes
Keywords: cutaneous melanoma, socioeconomic status, racial disparities, African Americans, Hispanic patients, Asian Americans, overall survival, treatment disparities, early-stage melanoma, surgical treatment, California Cancer Registry
MeSH terms: Aged, Aged, 80 and over, California, Ethnicity, Female, Humans, Male, Melanoma, Neoplasm Invasiveness, Neoplasm Staging, Retrospective Studies, Skin Neoplasms, Social Class, Socioeconomic Factors, United States, Cohort Studies, Survival Rate, SEER Program

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Survival for Patients With Invasive Cutaneous Melanoma Among Ethnic Groups: The Effects of Socioeconomic Status and Treatment

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