Racial, Sex, and Socioeconomic Inequities in Melanoma Surgical Interventions & Outcomes: A Multivariate Analysis
|Addison Demer, MD
|Medical Student Award
|Mayo Foundation for Medical Education and Research
|Honoring Richard Arthur Draeger from his Family
Background: Racial inequities in melanoma survival have been documented in the literature. The largest Black-white difference in overall cancer survival is for melanoma and has been worsening in recent years. Surgery remains the standard of care for localized, primary cutaneous invasive melanoma.
Objective: To determine if differences in the time to intervention, surgical approaches, and surgical outcomes may contribute to the current, stark disparities in melanoma survival outcomes between non-Hispanic white and Black individuals.
Methods: Analysis of melanoma data from the National Cancer database from 2008 to 2017. The national cancer database is part of an ongoing collaboration between the Commission on Cancer of the American College of Surgeons and the American Cancer Society and is the largest clinical registry world, capturing
most of the cancer diagnosis in the United States.
Results: Controlling for other confounding factors such as type of melanoma, thickness of tumor, type of medical institutions among others, we seek to determine if differences exist in time to intervention, post-operative complications, and use of surgical techniques between non-Hispanic white and Black individuals.
Limitations: Database study, limited data on racial minority patients in database. Observational studies and retrospective analyses cannot prove causation but rather reveal correlations that may ultimately highlight areas of future study.
Conclusions: By identifying differences in melanoma surgical treatment among patients of varying racial/ethnic backgrounds, we ultimately hope to promote improved patient outcomes and reduce melanoma mortality through research-based interventions.