The Odds of Stage IV Melanoma Diagnoses Based on Socioeconomic Factors

Mary Dick, Sarah Aurit, Peter Silberstein

Research output: Contribution to journalArticle

Abstract

BACKGROUND: When diagnosed at stage 0-I, melanoma has a 5-year survival rate of 92% to 100% in comparison with stage IV, which has a 5-year survival rate of 15% to 20%. OBJECTIVE: The objective of this article is to identify what socioeconomic and demographic factors were associated with increased odds in receiving a delayed melanoma diagnosis. METHODS: This study analyzed the odds of 108,628 patients from the National Cancer Database who were diagnosed between 2004 and 2012 with American Joint Committee on Cancer stage 0-I and stage IV based on race, sex, insurance type, income, facility type, and education. RESULTS: We identified significantly (P < .05) increased odds of stage IV primary melanoma diagnosis in those who had nonprivate insurance, including Medicare (odds ratio [OR] = 1.31, 95% confidence interval [CI]: 1.19-1.45), other government insurance (OR = 2.19, 95% CI: 1.61-2.98), Medicaid (OR = 6.97, 95% CI: 5.98-8.13), or no insurance (OR = 5.10, 95% CI: 4.41-5.91). Increased odds of late-stage melanoma were also associated with male sex (OR = 1.46, 95% CI: 1.36-1.57), race and ethnicity other than non-Hispanic white such as Hispanic whites (OR = 1.49, 95% CI: 1.15-1.92) or African Americans (OR=4.81, 95% CI: 3.75-6.18), and who had decreased education (OR = 1.19, 95% CI: 1.09-1.30). There was not a significant increase in odds of late-stage melanoma in patients from areas with the lowest levels of income compared with areas of highest income. CONCLUSIONS: Certain socioeconomic and demographic factors are associated with odds of a later-stage melanoma diagnosis.

Original languageEnglish (US)
Pages (from-to)421-427
Number of pages7
JournalJournal of cutaneous medicine and surgery
Volume23
Issue number4
DOIs
StatePublished - Jul 1 2019
Externally publishedYes

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Melanoma
Odds Ratio
Confidence Intervals
Insurance
Survival Rate
Demography
Education
Delayed Diagnosis
Sex Ratio
Medicaid
Medicare
Hispanic Americans
African Americans
Neoplasms
Databases

All Science Journal Classification (ASJC) codes

  • Surgery
  • Dermatology

Cite this

The Odds of Stage IV Melanoma Diagnoses Based on Socioeconomic Factors. / Dick, Mary; Aurit, Sarah; Silberstein, Peter.

In: Journal of cutaneous medicine and surgery, Vol. 23, No. 4, 01.07.2019, p. 421-427.

Research output: Contribution to journalArticle

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title = "The Odds of Stage IV Melanoma Diagnoses Based on Socioeconomic Factors",
abstract = "BACKGROUND: When diagnosed at stage 0-I, melanoma has a 5-year survival rate of 92{\%} to 100{\%} in comparison with stage IV, which has a 5-year survival rate of 15{\%} to 20{\%}. OBJECTIVE: The objective of this article is to identify what socioeconomic and demographic factors were associated with increased odds in receiving a delayed melanoma diagnosis. METHODS: This study analyzed the odds of 108,628 patients from the National Cancer Database who were diagnosed between 2004 and 2012 with American Joint Committee on Cancer stage 0-I and stage IV based on race, sex, insurance type, income, facility type, and education. RESULTS: We identified significantly (P < .05) increased odds of stage IV primary melanoma diagnosis in those who had nonprivate insurance, including Medicare (odds ratio [OR] = 1.31, 95{\%} confidence interval [CI]: 1.19-1.45), other government insurance (OR = 2.19, 95{\%} CI: 1.61-2.98), Medicaid (OR = 6.97, 95{\%} CI: 5.98-8.13), or no insurance (OR = 5.10, 95{\%} CI: 4.41-5.91). Increased odds of late-stage melanoma were also associated with male sex (OR = 1.46, 95{\%} CI: 1.36-1.57), race and ethnicity other than non-Hispanic white such as Hispanic whites (OR = 1.49, 95{\%} CI: 1.15-1.92) or African Americans (OR=4.81, 95{\%} CI: 3.75-6.18), and who had decreased education (OR = 1.19, 95{\%} CI: 1.09-1.30). There was not a significant increase in odds of late-stage melanoma in patients from areas with the lowest levels of income compared with areas of highest income. CONCLUSIONS: Certain socioeconomic and demographic factors are associated with odds of a later-stage melanoma diagnosis.",
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N2 - BACKGROUND: When diagnosed at stage 0-I, melanoma has a 5-year survival rate of 92% to 100% in comparison with stage IV, which has a 5-year survival rate of 15% to 20%. OBJECTIVE: The objective of this article is to identify what socioeconomic and demographic factors were associated with increased odds in receiving a delayed melanoma diagnosis. METHODS: This study analyzed the odds of 108,628 patients from the National Cancer Database who were diagnosed between 2004 and 2012 with American Joint Committee on Cancer stage 0-I and stage IV based on race, sex, insurance type, income, facility type, and education. RESULTS: We identified significantly (P < .05) increased odds of stage IV primary melanoma diagnosis in those who had nonprivate insurance, including Medicare (odds ratio [OR] = 1.31, 95% confidence interval [CI]: 1.19-1.45), other government insurance (OR = 2.19, 95% CI: 1.61-2.98), Medicaid (OR = 6.97, 95% CI: 5.98-8.13), or no insurance (OR = 5.10, 95% CI: 4.41-5.91). Increased odds of late-stage melanoma were also associated with male sex (OR = 1.46, 95% CI: 1.36-1.57), race and ethnicity other than non-Hispanic white such as Hispanic whites (OR = 1.49, 95% CI: 1.15-1.92) or African Americans (OR=4.81, 95% CI: 3.75-6.18), and who had decreased education (OR = 1.19, 95% CI: 1.09-1.30). There was not a significant increase in odds of late-stage melanoma in patients from areas with the lowest levels of income compared with areas of highest income. CONCLUSIONS: Certain socioeconomic and demographic factors are associated with odds of a later-stage melanoma diagnosis.

AB - BACKGROUND: When diagnosed at stage 0-I, melanoma has a 5-year survival rate of 92% to 100% in comparison with stage IV, which has a 5-year survival rate of 15% to 20%. OBJECTIVE: The objective of this article is to identify what socioeconomic and demographic factors were associated with increased odds in receiving a delayed melanoma diagnosis. METHODS: This study analyzed the odds of 108,628 patients from the National Cancer Database who were diagnosed between 2004 and 2012 with American Joint Committee on Cancer stage 0-I and stage IV based on race, sex, insurance type, income, facility type, and education. RESULTS: We identified significantly (P < .05) increased odds of stage IV primary melanoma diagnosis in those who had nonprivate insurance, including Medicare (odds ratio [OR] = 1.31, 95% confidence interval [CI]: 1.19-1.45), other government insurance (OR = 2.19, 95% CI: 1.61-2.98), Medicaid (OR = 6.97, 95% CI: 5.98-8.13), or no insurance (OR = 5.10, 95% CI: 4.41-5.91). Increased odds of late-stage melanoma were also associated with male sex (OR = 1.46, 95% CI: 1.36-1.57), race and ethnicity other than non-Hispanic white such as Hispanic whites (OR = 1.49, 95% CI: 1.15-1.92) or African Americans (OR=4.81, 95% CI: 3.75-6.18), and who had decreased education (OR = 1.19, 95% CI: 1.09-1.30). There was not a significant increase in odds of late-stage melanoma in patients from areas with the lowest levels of income compared with areas of highest income. CONCLUSIONS: Certain socioeconomic and demographic factors are associated with odds of a later-stage melanoma diagnosis.

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