Disparity in melanoma: A trend analysis of melanoma incidence and stage at diagnosis among whites, Hispanics, and blacks in Florida

Shasa Hu, Yisrael Parmet, Glenn Allen, Dorothy F. Parker, Fangchao Ma, Panta Rouhani, Robert Kirsner

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Abstract

Objective: To examine and compare the temporal trends in melanoma incidence and stage at diagnosis among whites, Hispanics, and blacks in Florida from 1990 to 2004. Design: Cross-sectional and retrospective analysis. Setting: Florida Cancer Data System. Patients: Melanoma cases with known stage and race/ ethnicity reported from 1990 to 2004. Main Outcome Measures: Age-adjusted melanoma incidence and stage at diagnosis. Results: Of 41 072 cases of melanoma, 39 670 cases were reported for white non-Hispanics (WNHs), 1148 for white Hispanics (WHs), and 254 for blacks. Melanoma incidence rates increased by 3.0% per year amongWNHmen (P<.001), 3.6% among WNH women (P<.001), 3.4% among WH women (P=.01), and 0.9% among WH men (P=.52), while remaining relatively stable among black men and women. Both WHs and blacks had significantly more advanced melanoma at presentation: 18% of WHand 26% of black patients had either regional or distant-stage melanoma at diagnosis compared with 12% of WNH patients. The proportion of distant-stage melanoma diagnosed among WHs and blacks changed little from 1990 to 2004, compared with a steady decrease in the percentage of melanoma cases diagnosed at distant stage among WNHs (P<.001). Such differences in the time trends of the proportion of distant-stage melanoma remained after excluding in situ cases. Conclusions: The rising melanoma incidence among WNHs and WHs emphasizes the need for primary prevention. The persistence of disparity in melanoma stage at diagnosis among WHs, blacks, and WNHs warrants closer examination of secondary prevention efforts in minority groups.

Original languageEnglish
Pages (from-to)1369-1374
Number of pages6
JournalArchives of Dermatology
Volume145
Issue number12
DOIs
StatePublished - Dec 1 2009

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Hispanic Americans
Melanoma
Incidence
hydroquinone
Minority Groups
Primary Prevention
Secondary Prevention
Information Systems
Cross-Sectional Studies
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Dermatology

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Disparity in melanoma : A trend analysis of melanoma incidence and stage at diagnosis among whites, Hispanics, and blacks in Florida. / Hu, Shasa; Parmet, Yisrael; Allen, Glenn; Parker, Dorothy F.; Ma, Fangchao; Rouhani, Panta; Kirsner, Robert.

In: Archives of Dermatology, Vol. 145, No. 12, 01.12.2009, p. 1369-1374.

Research output: Contribution to journalArticle

Hu, Shasa ; Parmet, Yisrael ; Allen, Glenn ; Parker, Dorothy F. ; Ma, Fangchao ; Rouhani, Panta ; Kirsner, Robert. / Disparity in melanoma : A trend analysis of melanoma incidence and stage at diagnosis among whites, Hispanics, and blacks in Florida. In: Archives of Dermatology. 2009 ; Vol. 145, No. 12. pp. 1369-1374.
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AU - Rouhani, Panta

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N2 - Objective: To examine and compare the temporal trends in melanoma incidence and stage at diagnosis among whites, Hispanics, and blacks in Florida from 1990 to 2004. Design: Cross-sectional and retrospective analysis. Setting: Florida Cancer Data System. Patients: Melanoma cases with known stage and race/ ethnicity reported from 1990 to 2004. Main Outcome Measures: Age-adjusted melanoma incidence and stage at diagnosis. Results: Of 41 072 cases of melanoma, 39 670 cases were reported for white non-Hispanics (WNHs), 1148 for white Hispanics (WHs), and 254 for blacks. Melanoma incidence rates increased by 3.0% per year amongWNHmen (P<.001), 3.6% among WNH women (P<.001), 3.4% among WH women (P=.01), and 0.9% among WH men (P=.52), while remaining relatively stable among black men and women. Both WHs and blacks had significantly more advanced melanoma at presentation: 18% of WHand 26% of black patients had either regional or distant-stage melanoma at diagnosis compared with 12% of WNH patients. The proportion of distant-stage melanoma diagnosed among WHs and blacks changed little from 1990 to 2004, compared with a steady decrease in the percentage of melanoma cases diagnosed at distant stage among WNHs (P<.001). Such differences in the time trends of the proportion of distant-stage melanoma remained after excluding in situ cases. Conclusions: The rising melanoma incidence among WNHs and WHs emphasizes the need for primary prevention. The persistence of disparity in melanoma stage at diagnosis among WHs, blacks, and WNHs warrants closer examination of secondary prevention efforts in minority groups.

AB - Objective: To examine and compare the temporal trends in melanoma incidence and stage at diagnosis among whites, Hispanics, and blacks in Florida from 1990 to 2004. Design: Cross-sectional and retrospective analysis. Setting: Florida Cancer Data System. Patients: Melanoma cases with known stage and race/ ethnicity reported from 1990 to 2004. Main Outcome Measures: Age-adjusted melanoma incidence and stage at diagnosis. Results: Of 41 072 cases of melanoma, 39 670 cases were reported for white non-Hispanics (WNHs), 1148 for white Hispanics (WHs), and 254 for blacks. Melanoma incidence rates increased by 3.0% per year amongWNHmen (P<.001), 3.6% among WNH women (P<.001), 3.4% among WH women (P=.01), and 0.9% among WH men (P=.52), while remaining relatively stable among black men and women. Both WHs and blacks had significantly more advanced melanoma at presentation: 18% of WHand 26% of black patients had either regional or distant-stage melanoma at diagnosis compared with 12% of WNH patients. The proportion of distant-stage melanoma diagnosed among WHs and blacks changed little from 1990 to 2004, compared with a steady decrease in the percentage of melanoma cases diagnosed at distant stage among WNHs (P<.001). Such differences in the time trends of the proportion of distant-stage melanoma remained after excluding in situ cases. Conclusions: The rising melanoma incidence among WNHs and WHs emphasizes the need for primary prevention. The persistence of disparity in melanoma stage at diagnosis among WHs, blacks, and WNHs warrants closer examination of secondary prevention efforts in minority groups.

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