DOI: http://dx.doi.org/10.18203/2349-3933.ijam20175518

Differences in survival by race/ethnicity among cutaneous melanoma patients in the United States over a period from 1982 to 2011

Abdulrahman M. Nasiri, Elharith S. Al-Akeel, Nora H. Rayes

Abstract


Background: Melanoma is an aggressive skin cancer with a high mortality rate. The incidence of melanoma has increased in recent years from 1:1500 in 1935 to 1:50 in 2011. The aim of this study is to investigate survival by race/ethnicity, taking site into account, among melanoma patients in the United States.

Methods: This study is a secondary analysis of the Surveillance, Epidemiology, and End Results (SEER) Program. SEER collects data through a non-concurrent cohort study design. The sample size was 185219 participants. The chi-square test was used to examine the association between categorical variables. Kaplan-Meier survival analysis was used to estimate the overall survival curve and to estimate the survival curve per race/ethnicity. Collinearity was assessed using Pearson correlation. Cox proportional hazards regression was used to calculate the unadjusted and adjusted hazard ratios (HR).

Results: Non-Hispanic White (NHW) and Other patients were older in age (70 years or older), while non-Hispanic Black (NHB) and Hispanic patients were younger (30-39 years). Melanoma in NHW patients was mostly located in trunk whereas melanoma for NHB, Hispanic and Other patients was mostly located in the lower limbs. For all races/ethnicities except for NHB, more individuals were diagnosed between 2002 and 2011. Patients with melanoma in upper limbs lived more frequently. Fewer women died (6.8%) compared to men (17.1%). Patients who were diagnosed between the ages of 30-39 were more likely to die. NHB had an adjusted HR of 3 (95% CI 2.7, 3.3) compared to NHW. The adjusted HR of lower limb was 1.6 (95% CI 1.5, 1,6) compared to the reference group (Head and Neck). The hazard for trunk and lower limb were about the same as the reference. Those who were 70 years or older had an adjusted HR of 2.2 (95% CI 2.0, 2.4). Women had an adjusted HR of 0.4 (95% CI 0.4, 0.5), and diagnosis during the decade 1982-1991 had an adjusted HR of 2.6 (95% CI 2.4, 2.7).

Conclusions: NHB patients and patients of ages 30-39 years were more likely to die. The poorest survival was for diagnosis between 1982 and 1991. However, more individuals were diagnosed between 2002 and 2011. The lower limb had a worse prognosis with adjusted HR of 1.6 (95% CI 1.5, 1,6), and more men were diagnosed than women.


Keywords


Cancer, Epidemiology and end results (SEER) program, Incidence, Melanoma, Mortality, Races/ethnicities

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