Southeast Asian patients were found to have higher rates of acral lentiginous melanoma as well as more advanced disease at diagnosis.
Clinical Pearls
This database study aimed to better characterize cutaneous melanoma among the Asian American and Pacific Islander population using the Surveillance, Epidemiology, and End Results (SEER) database
1,732 cases of cutaneous melanoma were identified, with superficial spreading melanoma being the most common subtype overall (40.7%) followed by acral lentiginous melanoma (23%) and nodular melanoma (17.8%)
Southeast Asian patients were found to have higher rates of acral lentiginous melanoma as well as more advanced disease at diagnosis
Discussion:
In this research letter published in the Journal of the American Academy of Dermatology, the authors investigated how cutaneous melanoma presentation differs within the Asian American and Pacific Islander population. Using the Surveillance, Epidemiology, and End Results (SEER) database, which divided the AAPI ethnic groups into regional groups (East Asian, South Asian, Southeast Asian, and Native Hawaiian and Pacific Islander), the authors reported 1,732 cases of cutaneous melanoma.
The most common melanoma subtypes reported overall were superficial spreading (40.7%), acral lentiginous (23%), and nodular (17.8%). The most common location overall was the lower extremity/hip (38.2%). Males were more commonly affected in all AAPI regional groups except East Asians. Additionally, superficial spreading melanoma was the most common subtype in all AAPI regional groups except Southeast Asians. The authors also found Southeast Asians suffered from higher rates of ulceration and metastatic melanoma at diagnosis when compared to other groups. To explain these disparities, the authors suggested that Vietnamese patients (within the Southeast Asian regional group) have the highest uninsured rates among all AAPI regional groups.
Overall, this database study provides valuable insight into disparities within AAPI groups in the presentation of cutaneous melanoma. One limitation to this study is its data was limited to the years 1990-2014 due to availability of the race recode variable. Additionally, there was a significant number of melanomas within this population which were not specified by subtype due to incomplete data, limiting the strength of this study.
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