title: Socioeconomic factors and diagnosis of uveal melanoma in the mid-southern United States.
abstract: OBJECTIVE
  To establish the base incidence of uveal melanoma in the mid-southern United States and to explore the regional frequency of uveal melanoma diagnosis as a function of area-based socioeconomic measures (ABSM) aggregated at the level of small geographic units delimited by Zoning Improvement Plan (ZIP) codes.
  
  
  METHODS
  Based on a retrospective chart review (1996-2007) of patients seen at our institutions with the diagnosis of uveal melanoma, the number of uveal melanoma cases was calculated for each ZIP-code in Arkansas, Mississippi, western Tennessee and Louisiana. The base incidence of uveal melanoma was calculated using the population size reported in the 2000 census as the population at risk for each geographic area. Data on the average house value and average household income reported in the 2000 census were used in a Poisson regression analysis to examine their effect on the frequency of uveal melanoma diagnosis.
  
  
  RESULTS
  There were 327 (of 1,669) regional ZIP-codes that were the source of 457 patients with uveal melanoma. Higher ABSM, defined as greater average house value or household income, were positively associated with the number of observed melanoma cases per ZIP-code. The annualized incidence of uveal melanoma was at least 3.5 cases per million in the areas studied.
  
  
  CONCLUSIONS
  Higher ABSM were associated with the increased frequency of uveal melanoma diagnosis in the regions studied. Extrapolating from similar trends observed with non-ocular cancers, this may signify a need for increased access to ophthalmologic care to ensure timely diagnosis.
authors.affiliation: Hamilton Eye Institute, Department of Ophthalmology, University of Tennessee Health Science Center, Tennessee, USA.
authors.forename: Yevgeniy
authors.initials: Y
authors.lastname: Shildkrot
authors.forename: Fridtjof
authors.initials: F
authors.lastname: Thomas
authors.forename: Adham
authors.initials: A
authors.lastname: Al-Hariri
authors.forename: Constance L
authors.initials: CL
authors.lastname: Fry
authors.forename: Barrett G
authors.initials: BG
authors.lastname: Haik
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Wilson
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology*; D011159:Population Surveillance; D012189:Retrospective Studies; D012307:Risk Factors; D018434:Sickness Impact Profile; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D014604:Uveal Neoplasms / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology*; D000098943:Uveal Melanoma