Disparities in the Presentation and Management of Cutaneous Melanoma That Required Admission

Oncology. 2018;95(2):69-80. doi: 10.1159/000468152. Epub 2018 Jun 18.

Abstract

Objective: In this study, we aimed to examine the association of demographic and socioeconomic factors with cutaneous melanoma that required admission.

Methods: A cross-sectional study utilizing the Nationwide Inpatient Sample database, 2003-2009, was merged with County Health Rankings Data.

Results: A total of 2,765 discharge -records were included. Men were more likely to have melanoma in the head, neck, and trunk regions (p < 0.001), while extremities melanoma was more common in women (p < 0.001). Males had a higher risk of lymph node metastasis on presentation (OR 1.54, 95% CI [1.27-1.89]). Blacks and Hispanics were more likely to present with extremities melanoma. Patients with low annual income were more likely to be treated by low-volume surgeons and in hospitals located in high-risk communities (p < 0.05 each). Patients with Medicaid coverage were twice as likely to present with distant metastasis and were more likely to be managed by low-volume surgeons (p < 0.05 each).

Conclusions: The presentation and outcomes of cutaneous melanoma have a distinct pattern of distribution based on patients' characteristics.

Keywords: Healthcare disparities; Inpatients; Melanoma; Outcome assessment; Social class.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Databases, Factual
  • Female
  • Head and Neck Neoplasms / diagnosis
  • Head and Neck Neoplasms / epidemiology*
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / therapy*
  • Healthcare Disparities / statistics & numerical data*
  • Humans
  • Lymphatic Metastasis / pathology
  • Male
  • Melanoma / diagnosis
  • Melanoma / epidemiology*
  • Melanoma / pathology
  • Melanoma / therapy*
  • Melanoma, Cutaneous Malignant
  • Middle Aged
  • Sex Factors
  • Skin Neoplasms / diagnosis
  • Skin Neoplasms / epidemiology*
  • Skin Neoplasms / pathology
  • Skin Neoplasms / therapy*
  • Socioeconomic Factors
  • United States / epidemiology