title: Disparity in melanoma: a trend analysis of melanoma incidence and stage at diagnosis among whites, Hispanics, and blacks in Florida.
abstract: OBJECTIVE
  To examine and compare the temporal trends in melanoma incidence and stage at diagnosis among whites, Hispanics, and blacks in Florida from 1990 to 2004.
  
  
  METHODS
  Cross-sectional and retrospective analysis.
  
  
  METHODS
  Florida Cancer Data System.
  
  
  METHODS
  Melanoma cases with known stage and race/ethnicity reported from 1990 to 2004.
  
  
  METHODS
  Age-adjusted melanoma incidence and stage at diagnosis.
  
  
  RESULTS
  Of 41 072 cases of melanoma, 39 670 cases were reported for white non-Hispanics (WNHs), 1148 for white Hispanics (WHs), and 254 for blacks. Melanoma incidence rates increased by 3.0% per year among WNH men (P < .001), 3.6% among WNH women (P < .001), 3.4% among WH women (P = .01), and 0.9% among WH men (P = .52), while remaining relatively stable among black men and women. Both WHs and blacks had significantly more advanced melanoma at presentation: 18% of WH and 26% of black patients had either regional or distant-stage melanoma at diagnosis compared with 12% of WNH patients. The proportion of distant-stage melanoma diagnosed among WHs and blacks changed little from 1990 to 2004, compared with a steady decrease in the percentage of melanoma cases diagnosed at distant stage among WNHs (P < .001). Such differences in the time trends of the proportion of distant-stage melanoma remained after excluding in situ cases.
  
  
  CONCLUSIONS
  The rising melanoma incidence among WNHs and WHs emphasizes the need for primary prevention. The persistence of disparity in melanoma stage at diagnosis among WHs, blacks, and WNHs warrants closer examination of secondary prevention efforts in minority groups.
authors.affiliation: Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.
authors.forename: Shasa
authors.initials: S
authors.lastname: Hu
authors.forename: Yisrael
authors.initials: Y
authors.lastname: Parmet
authors.forename: Glenn
authors.initials: G
authors.lastname: Allen
authors.forename: Dorothy F
authors.initials: DF
authors.lastname: Parker
authors.forename: Fangchao
authors.initials: F
authors.lastname: Ma
authors.forename: Panta
authors.initials: P
authors.lastname: Rouhani
authors.forename: Robert S
authors.initials: RS
authors.lastname: Kirsner
mesh_terms: D000328:Adult; D044383:Black People / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D005431:Florida / Q000453:epidemiology; D054624:Health Status Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000208:ethnology* / Q000473:pathology; D009367:Neoplasm Staging; D012189:Retrospective Studies; D017678:Sex Distribution; D012878:Skin Neoplasms / Q000208:ethnology* / Q000473:pathology; D044465:White People / Q000706:statistics & numerical data*; D001741:Black or African American