Advertisement

Advanced presentation of melanoma in African Americans

      Abstract

      Background

      Melanoma in African Americans is rare, and the diagnosis is often delayed, leading to advanced presentation and poor prognosis.

      Objective

      The purpose of this retrospective study is to determine whether African American patients diagnosed with melanoma at the Washington Hospital Center were initially seen with more advanced disease than white patients.

      Methods

      A retrospective chart review was performed on 36 African American patients who were diagnosed and/or treated for melanoma at the Washington Hospital Center between 1981 and 2000. Data obtained included patient age at presentation, sex, Breslow's depth and histologic subtype, stage at presentation, and tumor location. These data were compared with information obtained from white patients with melanoma during this period.

      Results

      A total of 649 African American and white patients were treated for melanoma at the Washington Hospital Center between 1981 and 2000. Of these, 36 (6.1%) patients were African American. African American patients were more likely to initially be seen with stage III/IV disease (32.1%) compared with (12.7%) the white patients initially seen with these disease stages. Of the white patients 60.4% were initially seen with melanoma in situ/stage I disease compared with 39.3% of the African American patients. The 5-year survival rate was 58.8% in African Americans compared with 84.8% in whites.

      Conclusions

      In our series, African Americans are more likely than whites to be initially seen with advanced disease and have a subsequent worse prognosis. Physician training and patient education campaigns are crucial to improving the poor prognosis associated with melanoma in the African American community.
      To read this article in full you will need to make a payment
      AAD Member Login
      AAD Members, full access to the journal is a member benefit. Use your society credentials to access all journal content and features
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • American Cancer Society
        Cancer facts and figures.
        American Cancer Society, Atlanta2003 (. p. 1-52)
        • Halder R.M.
        • Bridgeman-Shah S.
        Skin cancer in African Americans.
        Cancer. 1995; 75: 667-673
      1. National Cancer Institute SEER Cancer Statistics Review 1973-1998; Section 16, Melanoma of the Skin: Melanoma of skin (invasive) SEER incidence rates, age-adjusted and age-specific rates, by race and sex. Available from: URL:http://seer.cancer.gov/publications/CSR 1973-1998

        • Shah J.P.
        • Goldsmith H.S.
        Malignant melanoma in the North American Negro.
        Surg Gynecol Obstet. 1971; 133: 437-439
        • Runkle G.P.
        • Zalpznik A.J.
        Malignant melanoma.
        Am Fam Physician. 1994; 49: 91-98
        • Cress R.D.
        • Holly E.A.
        Incidence of cutaneous melanoma among non-Hispanic whites, Hispanics, Asians, and Blacks.
        Cancer Causes Control. 1997; 8: 246-252
        • Wingo P.A.
        • Bolden S.
        • Tong T.
        • Parker S.L.
        • Martin L.M.
        • Heath Jr, C.W.
        Cancer statistics for African Americans, 1996.
        CA Cancer J Clin. 1996; 46: 113-125
        • Bibb S.C.
        Access and late-stage diagnosis of breast cancer in the military health system.
        Milit Med. 2000; 165: 585-590
        • Demers R.Y.
        • Severson R.K.
        • Schottenfeld D.
        • Lazar L.
        Incidence of colorectal adenocarcinoma by anatomic subsite. An epidemiologic study of time trends and racial differences in the Detroit, Michigan area.
        Cancer. 1997; 79: 441-447
        • Lannin D.R.
        • Mathews H.F.
        • Mitchell J.
        • Swanson M.S.
        • Swanson F.H.
        • Edwards M.S.
        Influence of socioeconomic and cultural factors on racial differences in late-stage presentation of breast cancer.
        JAMA. 1998; 279: 1801-1807
        • Hudson D.A.
        • Krige J.E.
        • Stubbings H.
        Plantar melanoma.
        Surgery. 1998; 124: 877-882
        • Hudson D.A.
        • Krige J.E.
        Melanoma in Black South Africans.
        J Am Coll Surg. 1995; 180: 65-71
        • Reintgen D.S.
        • McCarty K.S.
        • Cox E.
        • Seigler H.F.
        Malignant melanoma in Black American and white American populations.
        JAMA. 1982; 248: 1856-1859
        • Crowley N.J.
        • Dodge R.
        • Vollmer R.T.
        • Seigler H.F.
        Malignant melanoma in Black Americans.
        Arch Surg. 1991; 126: 1359-1365
      2. Krementz ET, Sutherland CM, Carter D, Ryan RF. Malignant melanoma in the American Black. Ann Surg 1976:533-41

        • Katz R.D.
        • Potter G.K.
        • Slutskiy P.Z.
        • Smith R.L.
        • Pfau R.G.
        • Berlin S.J.
        A statistical survey of melanomas of the foot.
        J Am Acad Dermatol. 1993; 128: 1008-1011
        • Stevens N.G.
        • Liff J.M.
        • Weiss N.S.
        Plantar melanoma.
        Int J Cancer. 1990; 45: 691-693
        • Rigel D.S.
        • Carucci J.A.
        Malignant melanoma.
        CA Cancer J Clin. 2000; 50: 215-236
        • Whited J.D.
        • Grichnik J.M.
        Does this patient have a mole or a melanoma?.
        JMA. 1998; 279: 696-701