title: Racial disparities in melanoma survival.
abstract: BACKGROUND
  Melanoma is a cutaneous malignancy common in the white population but can also occur in other racial groups.
  
  
  OBJECTIVE
  We sought to evaluate survival across racial groups in patients given a diagnosis of malignant melanoma.
  
  
  METHODS
  The Surveillance, Epidemiology, and End Results database was used to populate a cohort of 96,953 patients given a diagnosis of cutaneous melanoma as their primary cancer, from 1992 to 2009.
  
  
  RESULTS
  White patients had the longest survival time (P < .05), followed by Hispanic (P < .05), Asian American/Native American/Pacific Islander (P < .05), and black (P < .05) patients, respectively. Survival stratified by race and stage showed that for stages I and III, blacks had a significantly lower survival (P < .05), and increased hazard ratios (stage I hazard ratio, 3.037 [95% confidence interval, 2.335-3.951]; stage III hazard ratio, 1.864 [95% confidence interval, 1.211-2.87]). The proportion of later stage cutaneous melanoma (stages II-IV) was greater in blacks compared with whites.
  
  
  CONCLUSIONS
  Despite higher incidence of cutaneous melanoma in whites, overall survival for cutaneous melanoma in non-whites was significantly lower. Our results suggest that more emphasis is needed for melanoma screening and awareness in non-white populations to improve survival outcomes.
authors.affiliation: Michigan State University College of Osteopathic Medicine, East Lansing, Michigan.
authors.forename: Sean M
authors.initials: SM
authors.lastname: Dawes
authors.affiliation: Case Western Reserve University School of Medicine, Cleveland, Ohio.
authors.forename: Sheena
authors.initials: S
authors.lastname: Tsai
authors.affiliation: Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio.
authors.forename: Haley
authors.initials: H
authors.lastname: Gittleman
authors.affiliation: Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio; Case Western Reserve University School of Medicine, Cleveland, Ohio.
authors.forename: Jill S
authors.initials: JS
authors.lastname: Barnholtz-Sloan
authors.affiliation: Department of Dermatology, University Hospitals Case Medical Center, Cleveland, Ohio. Electronic address: jeremy.bordeaux@uhhospitals.org.
authors.forename: Jeremy S
authors.initials: JS
authors.lastname: Bordeaux
mesh_terms: D000368:Aged; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006293:Health Promotion; D006301:Health Services Needs and Demand; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008545:Melanoma / Q000208:ethnology* / Q000401:mortality; D008875:Middle Aged; D016016:Proportional Hazards Models; D044469:Racial Groups / Q000706:statistics & numerical data*; D018426:SEER Program; D012878:Skin Neoplasms / Q000208:ethnology* / Q000401:mortality; D012880:Skin Pigmentation; D012959:Socioeconomic Factors; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology; D000096142:Cutaneous Malignant Melanoma
keywords: Asian American/Native American/Pacific Islander; black; epidemiology; health outcomes; melanoma; public health; race; stage; survival; white