Melanoma Detection in Racial, Ethnic Minorities Evaluated
Researchers observed a low incidence of melanoma and low detection rates among a large racial and ethnic minority cohort.
Researchers investigated melanoma incidence and presentation in 60,680 Hispanic, American Indian or Alaska Native, Asian, Black, and Pacific Islander individuals.
Of the 60,680 patients, 12,738 were screened for skin cancer and 47,942 were not.
The median age of the cohort was 51 years, and 60% were female.
Data were analyzed from January 2020 to May 2023.
Most patients were Black (77.9%), while 14.5% were Asian, 6.8% were Hispanic, 1.2% were American Indian or Alaska Native, and 0.4% were Pacific Islander.
A total of eight melanomas were diagnosed over the study period: three in screened and five in unscreened individuals, including one nodular and one acral lentiginous subtype in unscreened Blacks.
Of the eight melanomas, one was identified during a screening visit, two by the patient or a family member, and four by clinicians during visits for reasons other than skin cancer screening.
All patients with melanoma had seen their primary care clinician at least once in the 6 months prior to diagnosis, which the authors point out, suggested “potential missed opportunities for earlier diagnosis or that rapidly growing melanomas are less amenable to early physician detection through periodic screening.”
“The low absolute number of melanomas but their more aggressive nature, particularly in Black individuals…suggests that approaches other than routine skin cancer screening may be more useful in addressing screening disparities,” the authors write.
Laura K. Ferris, MD, PhD, of the department of dermatology at the University of Pittsburgh, led the study, which was published July 26 in JAMA Dermatology.
A nonrandomized study design, limited follow-up, relatively small proportion of racial and ethnic minority individuals, and a patient population that may not reflect the sociodemographic makeup in other geographic areas were limitations of the study.
Ferris reported personal fees from DermTech, Novartis, and Bristol Myers Squibb and grants from Castle Biosciences, Skin Analytics, and DermTech outside the submitted work.
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