The expanding melanoma burden in California hispanics

Importance of socioeconomic distribution, histologic subtype, and anatomic location

Authors

  • Ricardo A. Pollitt MD, PhD,

    Corresponding author
    1. Department of Dermatology, Pigmented Lesion and Melanoma Program, Stanford University Medical Center and Stanford Cancer Center, Stanford, California
    • Department of Dermatology, Stanford University Medical Center, 450 Broadway Street, Pavilion C, Second Floor, Redwood City, CA 94063
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    • Fax: (650) 721-3464

  • Christina A. Clarke PhD, MPH,

    1. Northern California Cancer Center, Fremont, California
    2. Department of Health Research and Policy, Stanford University Medical Center and Stanford Cancer Center, Stanford, California
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  • Susan M. Swetter MD,

    1. Department of Dermatology, Pigmented Lesion and Melanoma Program, Stanford University Medical Center and Stanford Cancer Center, Stanford, California
    2. Dermatology Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
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  • David H. Peng MD, MPH,

    1. Department of Clinical Dermatology, University of Southern California, Los Angeles, California
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  • John Zadnick MS,

    1. Department of Preventive Medicine, University of Southern California/Keck School of Medicine, Los Angeles, California
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  • Myles Cockburn PhD

    1. Department of Preventive Medicine, University of Southern California/Keck School of Medicine, Los Angeles, California
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  • The ideas and opinions expressed herein are those of the authors, and endorsement by the State of California Department of Public Health, the National Cancer Institute, the Centers for Disease Control and Prevention, or their contractors and subcontractors is not intended nor should be inferred.

Abstract

BACKGROUND:

The incidence patterns and socioeconomic distribution of cutaneous melanoma among Hispanics are poorly understood.

METHODS:

The authors obtained population-based incidence data for all Hispanic and non-Hispanic white (NHW) patients who were diagnosed with invasive cutaneous melanoma from 1988 to 2007 in California. By using a neighborhood-level measure of socioeconomic status (SES), the variables investigated included incidence, thickness at diagnosis, histologic subtype, anatomic site, and the relative risk (RR) for thicker (>2 mm) versus thinner (≤2 mm) tumors at diagnosis for groups categorized by SES.

RESULTS:

Age-adjusted melanoma incidence rates per million were higher in NHWs (P < .0001), and tumor thickness at diagnosis was greater in Hispanics (P < .0001). Sixty-one percent of melanomas in NHWs occurred in the High SES group. Among Hispanics, only 35% occurred in the High SES group; and 22% occurred in the Low SES group. Lower SES was associated with thicker tumors (P < .0001); this association was stronger in Hispanics. The RR of thicker tumors versus thinner tumors (≤2 mm) in the Low SES group versus the High SES group was 1.48 (95% confidence interval [CI], 1.37-1.61) for NHW men and 2.18 (95% CI, 1.73-2.74) for Hispanic men. Patients with lower SES had less of the superficial spreading melanoma subtype (especially among Hispanic men) and more of the nodular melanoma subtype. Leg/hip melanomas were associated with higher SES in NHW men but with lower SES in Hispanic men.

CONCLUSIONS:

The socioeconomic distribution of melanoma incidence and tumor thickness differed substantially between Hispanic and NHW Californians, particularly among men. Melanoma prevention efforts targeted to lower SES Hispanics and increased physician awareness of melanoma patterns among Hispanics are needed. Cancer 2011. © 2010 American Cancer Society.

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