“We already knew that black patients with melanoma have a worse prognosis and that longer time to treatment is associated with worse survival, but we didn’t fully understand the relationship between race and time to treatment after controlling for various other factors,” said study first author Raghav Tripathi, from Case Western Reserve University School of Medicine in Cleveland.
He and his colleagues analyzed data gathered from nearly 234,000 U.S. melanoma patients between 2004 and 2015. Of those, just over 1,200 (0.52%) were black. The rate of melanoma is relatively low in blacks.
The time from diagnosis to surgery was an average of 23.4 days for black patients, compared with 11.7 days for white patients. Compared to whites, blacks were two times more likely to have to wait 41-60 days, three times more likely to have to wait 61-90 days, and five times more likely to have to wait 91 days or more.
Overall, patients with Medicaid had the longest wait (an average of 60.4 days), and those with private insurance had the shortest (44.6 days).
Health insurance status didn’t fully account for the disparities in wait times between blacks and whites, according to the study authors.
“A more thorough understanding of the factors associated with worse outcomes for black patients is critical in reducing racial disparities in melanoma outcomes,” Tripathi said in a university news release.
Tripathi noted that blacks typically develop more aggressive melanoma and require more complex surgeries that can take longer to schedule, particularly if they involve coordination among several doctors.
Also, there tends to be low awareness about skin cancer among black Americans because it’s relatively rare among them.
“Ultimately, we hope this study will draw attention to the importance of further understanding the various components of [time from diagnosis to definitive surgery] and worse outcomes for black melanoma patients,” Tripathi said.
Additionally, this study suggests that targeted approaches to improve time to treatment of black patients are necessary in reducing racial disparities in melanoma outcomes, he added.
The findings were recently published in the Journal of the American Academy of Dermatology.
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Posted: June 2020