The ongoing racial disparities in melanoma: an analysis of the Surveillance, Epidemiology, and End Results database (SEER) database (1975-2016).

BACKGROUND Although the majority of cutaneous melanoma patients are non-Hispanic white (NHW), minorities consistently suffer worse melanoma specific survival (MSS). Much of the literature comes from analyses of registries from the 1990s and 2000s. OBJECTIVE To evaluate whether and to what degree racial disparity in MSS persists since 2010. METHODS We analyzed 381,035 patients from the Surveillance, Epidemiology, and End Results (SEER) registry. Race categories included Hispanic, NHW, non-Hispanic black (NHB), non-Hispanic Asian or Pacific Islander (NHAPI), and non-Hispanic American Indian/Alaska Native (NHAIAN). We evaluated the association between MSS and race in three time-periods: <2000, 2000-2009, and ≥2010. NHW was the reference group for all analyses. RESULTS Racial disparity worsened from <2000 to ≥2010 for Hispanic (P<0.001), NHB (P=0.024), and NHAPI (P<0.001) patients. Across all minority groups, patients with localized disease suffered increasing disparity (P=0.010 for Hispanic, P<0.001 for NHB, P=0.023 for NHAPI, and P=0.042 for NHAIAN). Among those with regional and distant disease, Hispanic patients were the only minority to experience worsening disparity (P=0.001 and P=0.019, respectively). LIMITATIONS Lack of immunotherapy and targeted treatment information CONCLUSIONS: Racial disparity in MSS is worsening. Improving post-diagnosis management for minorities with localized disease is imperative to mitigate disparity and improve survival.