Database Analysis Finds Certain Asian American Groups have Worse Melanoma-Specific Mortality

Kim DY, Dee EC, Cheng I, Hartman RI. Advanced melanoma presentation and disease-specific survival disparities among disaggregated Asian American, Native Hawaiian, and Pacific Islander populations. J Am Acad Dermatol. 2024 Mar;90(3):623-626. doi: 10.1016/j.jaad.2023.10.052. Epub 2023 Nov 3. PMID: 37923219.

Vietnamese patients had the worst 5 year melanoma specific survival compared than other groups comprising Asian Americans, Native Hawaiians, and Pacific Islanders.

Clinical Pearls

• The authors analyzed the SEER registries program to investigate melanoma-related health disparities among Asian Americans, Native Hawaiian, and Pacific Islanders overall and between each respective ethnicity within these groups.  

• Asian Americans as well as Native Hawaiians and Pacific Islanders presented with melanoma at younger ages and had higher rates of acral lentiginous melanoma than their white counterparts  

• Vietnamese patients had the worst 5 year melanoma specific survival compared than other groups comprising Asian Americans, Native Hawaiians, and Pacific Islanders

Discussion:

Researchers from Brigham and Women’s Hospital investigated how melanoma presentation and survival varies among Asian American (AA) and Native Hawaiian and Other Pacific Islander (NHOPI) patients. Of note, the authors emphasized how prior studies have found AA patients have poorer prognoses for melanoma when compared to their white counterparts. Furthermore, the authors specifically disaggregated AA and NHPOI groups to better understand how melanoma presentation and survival varies within these groups.

Using the Surveillance, Epidemiology, and End Results database, the authors were able to identify 206,707 AA and NHOPI patients diagnosed with primary malignant cutaneous melanoma from 2004-2019. Following disaggregation of AA and NHOPI populations and subsequent statistical analysis, the authors found Filipino, NHOPI, and Vietnamese patients were at greater odds of having distant metastases than their non-Hispanic White counterparts. Moreover, the authors also compared all disaggregated groups to Chinese patients and still found Filipino and Vietnamese patients had greater odds of having distant metastases. Finally, the authors found Vietnamese patients had the lowest 5-year melanoma specific survival compared to other disaggregated groups.

This study provides insights into previously uninvestigated melanoma survival and presentation differences of AA and NHOPI patients. Although its limited by its use of a database which does not account for healthcare access or education, this study can help identify which AA and NHOPI patients may require unique considerations.