Increased Odds of Treatment Delays Found in Asian American and Pacific Islanders with Melanoma

Fane LS, Wei AH, Tripathi R, Bordeaux JS. Asian American and Pacific Islander patients with melanoma have increased odds of treatment delays: A cross-sectional study. J Am Acad Dermatol. 2023 Sep;89(3):529-536. doi: 10.1016/j.jaad.2023.05.028. Epub 2023 May 22. PMID: 37224968.

359,943 patients were included, 1,155 (0.33%) of which were Asian American and Pacific Islander. This subset was found to have an average longer time from diagnosis to definitive surgery for melanoma

Clinical Pearls

• This retrospective review investigated the time from diagnosis of melanoma to definitive surgery in Asian American and Pacific Islander individuals

• 359,943 patients were included, 1,155 (0.33%) of which were Asian American and Pacific Islander. This subset was found to have an average longer time from diagnosis to definitive surgery for melanoma

Discussion:

In this retrospective review published in the Journal of the American Academy of Dermatology, Fane et al. investigate the time from diagnosis of melanoma to definitive surgery in Asian American and Pacific Islander (AAPI) patients as compared to non-Hispanic White (NHW) patients. The authors cited a previous article showing how AAPI patients with melanoma have higher mortality rates when compared to NHW, suggesting further research in this area is needed.

Using the National Cancer Database, the authors searched for AAPI and NHW patients diagnosed with cutaneous melanoma from 2004 to 2020. Patients with stage I through stage IV melanoma were included. Importantly, the authors used the time from diagnosis to treatment with definitive surgery (TTDS) quantified by the National Cancer Database to determine if treatment delayed occurred and in which populations they may occur in.

354,943 patients were included in the study sample, with 1,155 (0.33%) being of AAPI ethnicity and 353,788 (99.67%) being NHW. AAPI patients were found to present at younger ages with melanoma as well as presenting with later stages of melanoma. Interestingly, AAPI patients were found to have an average longer time from diagnosis to treatment with definitive surgery. AAPI patients also had higher rates of melanoma on the skin of the lower limb and hip.

This study provides valuable data on melanoma in Asian American and Pacific Islander individuals, highlighting the need to expedite definitive treatment in these patients. One limitation of this study is that the National Cancer Database may have limited generalizability to the U.S population due to a lack of data from rural hospitals.