title: Impact of Socioeconomic Status and Ethnicity on Melanoma Presentation and Recurrence in Caucasian Patients.
abstract: OBJECTIVE
  The impact of ethnicity and the socioeconomic status (SES) among Caucasians is not well studied. Here, we examine the impact of income on melanoma presentation and prognosis within a Caucasian cohort, accounting for ethnicity, as some reports suggest increased melanoma incidence in Ashkenazi Jewish (AJ) BRCA mutation carriers.
  
  
  METHODS
  We studied prospectively enrolled primary melanoma patients at New York University. SES data were estimated using United States' Census Bureau data and patient zip codes. We evaluated associations between ethnicity, SES, and baseline characteristics using the χ² test and multivariate logistic regression. We compared survival distributions using Kaplan-Meier curves, log-rank tests, and Cox proportional hazard ratios.
  
  
  RESULTS
  Of the 1,339 enrolled patients, AJ represented 32% (n = 423). Apart from AJ being older at presentation (p < 0.001), no significant differences were observed in baseline characteristics between ethnic groups. Patients with a median household income (MHI) lower than the median of the cohort were significantly more likely to present with advanced stages (p < 0.001) compared to patients with a higher MHI. Shorter overall (p = 0.016) and post-recurrence survival (p = 0.042) was also observed in patients from lower-income households.
  
  
  CONCLUSIONS
  Data suggest that disparities in melanoma presentation in Caucasians stratify according to income independent of ethnic background.
authors: Interdisciplinary Melanoma Cooperative Group, New York University School of Medicine, New York, N.Y., USA.
authors: Christine
authors: C
authors: Salvaggio
authors: Sung Won
authors: SW
authors: Han
authors: Kathryn
authors: K
authors: Martires
authors: Eric
authors: E
authors: Robinson
authors: Reshmi
authors: R
authors: Madankumar
authors: Priyanka
authors: P
authors: Gumaste
authors: David
authors: D
authors: Polsky
authors: Jennifer
authors: J
authors: Stein
authors: Russell
authors: R
authors: Berman
authors: Richard
authors: R
authors: Shapiro
authors: Judy
authors: J
authors: Zhong
authors: Iman
authors: I
authors: Osman
mesh_terms: D000328:Adult; D000368:Aged; D057210:Delayed Diagnosis / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D007585:Jews / Q000706:statistics & numerical data*; D053208:Kaplan-Meier Estimate; D008297:Male; D008545:Melanoma / Q000208:ethnology* / Q000401:mortality / Q000473:pathology*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality*; D009367:Neoplasm Staging; D009519:New York City / Q000453:epidemiology; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012878:Skin Neoplasms / Q000208:ethnology* / Q000401:mortality / Q000473:pathology*; D015996:Survival Rate; D044465:White People / Q000208:ethnology*