Social, economic factors impact skin cancer survival

NEW YORK (Reuters Health) - Low socioeconomic status is a strong predictor of poor survival among patients from different ethnic groups with melanoma skin cancer, new research indicates.

However, according to the researchers, the poor overall survival seen in African American melanoma patients is not explained by low socioeconomic status or differences in treatment.

“These data highlight the importance of melanoma control efforts directed at patients from all ethnic backgrounds,” Dr. Jason A. Zell, from University of California, Irvine, told Reuters Health.

The findings stem from 39,049 patients diagnosed with melanoma skin cancer between 1993 and 2003, including 36,694 in non-Hispanic whites; 127 in African Americans; 1,996 in Hispanics; and 262 in Asian or Pacific Islanders.

This analysis “represents the largest study to date to address ethnic differences in survival for melanoma while accounting for disparities in treatment and social and economic factors, Zell said.

Results showed that people of higher social and economic status were much more likely than those of lower socioeconomic status to be diagnosed with skin cancer at an early stage and to have surgery to excise the tumors. They also survived longer.

“In this study, socioeconomic status itself was found to be a strong predictor of survival,” Zell said, noting that melanoma patients with the highest, relative to the lowest, socioeconomic status were 37 percent less likely to die, even after accounting for differences in age, gender, cancer stage, and other factors.

He also noted that while melanoma is “quite uncommon” among African-Americans, “our data reveal that survival among African-American melanoma patients is poor,” and this is not explained by differences in cancer stage, treatment disparities, or differences in socioeconomic factors.

The adjusted risk of death was 60 percent higher in African Americans compared with non-Hispanic whites. No survival differences were observed for Asians or Hispanics compared with non-Hispanic whites.

Zell and colleagues say the potential “mechanistic explanations” for the findings are “speculative and must await future research.”

SOURCE: Journal of Clinical Oncology, January 1, 2008.