State-by-State Analysis of Melanoma: Predicting Differences in Survival
Posted: Friday, March 1, 2019
In the United States, states with the highest incidence of melanoma reported better survival rates than states with a lower incidence, according to findings presented in the Journal of the American Academy of Dermatology. Researchers found that regions with more practicing physicians and a higher population of white individuals had lower survival.
“Finding a significant relationship between more physicians and mortality was certainly surprising,” Zachary H. Hopkins, MD, of the University of Utah, Salt Lake City, said in an institutional press release. “We believe the sickest patients go to larger facilities with more doctors, which may also be more likely to report disease.”
The investigators calculated state-based mortality-to-incidence ratios using U.S. cancer statistics data from 2009 to 2014. The rates were compared with state-specific health-care variables and sociodemographic variables.
The mean overall mortality-to-incidence ratio was 0.15 ± 0.04 (with Alaska as the sole outlier at 0.24). Most states had ratios that decreased over time, with no states exhibiting an increase in rates. A multivariable analysis revealed that states with a higher percentage of non-Hispanic white individuals had higher ratios, and significant correlations were observed in regard to melanoma incidence (r = 0.72), melanoma mortality (r = 0.38), dermatologist density (r = 0.32), and National Cancer Institute–designated cancer centers count (r = 0.12).
“The analysis is telling us that two people with similar melanomas could have very different outcomes based on where they live and the care they receive,” explained senior study author Aaron M. Secrest, MD, PhD, of the University of Utah.
Disclosure: The study authors’ disclosure information may be found at jaad.org.