Despite higher incidence of cutaneous melanoma in Caucasians, the survival rate for cutaneous melanoma in patients with skin of colour is significantly lower, according to a study published online in the Journal of American Academy of Dermatology (July 28, 2016).
“Everyone is at risk for skin cancer, regardless of race,” said Cleveland-based dermatologist Dr. Jeremy S. Bordeaux, one of the study authors, in a press release. “Patients with skin of color may believe they aren’t at risk, but that is not the case—and when they do get skin cancer, it may be especially deadly.” Researchers at Case Western Reserve University in Cleveland utilized the U.S. National Cancer Institute’s Surveillance, Epidemiology and End Results database to study nearly 97,000 patients diagnosed with melanoma, from 1992 to 2009. Although Caucasian patients had the highest melanoma incidence rate, they also had the best overall survival rate, followed by Hispanic patients and patients in the Asian American/Native American/Pacific Islander group. African-American patients had the worst overall survival rate, and they were also the group most likely to be diagnosed with melanoma in its later stages, when the disease is more difficult to treat. According to the study, however, the timing of the diagnosis is not the only factor that affects this group’s survival rates, as African-American patients had the worst prognosis for every stage of melanoma. Dr. Bordeaux says these differences in survival rates may be due to disparities in the timeliness of melanoma detection and treatment among different races; for example, patients with skin of colour may not seek medical attention for irregular spots on their skin because they don’t believe these lesions pose a risk. Additionally, he says, there may be biologic differences in melanoma among patients with skin of colour, resulting in more aggressive disease in these patients. More research is necessary to determine why survival rates differ among different ethnic groups, he says, but in the meantime, patients with skin of colour should be aware of their skin cancer risk. Dr. Bordeaux noted that people with skin of colour are prone to skin cancer in areas that are not commonly exposed to the sun, including the palms of the hands and the soles of the feet. He said these individuals should be especially careful to examine hard-to-see areas when monitoring their skin for signs of skin cancer, and should ask a partner to help if necessary.