Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] · 2023
Racial-Ethnic, Education, and Socioeconomic Differences in the Treatment of Head and Neck Melanoma in situ: A Surveillance Epidemiology and End Results Population-Based Analysis.
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Tran Andrew X, Barriera Paola, Xiong David, Knackstedt Thomas
Аннотация
BACKGROUND: Incidence and treatment disparities for cutaneous melanomas have been documented among racial and sociodemographic minorities. However, the association between treatment types, race, and socioeconomic status remains unknown.
OBJECTIVE: To characterize treatment differences for head and neck melanoma in situ (MIS) and lentigo maligna (LM) based on race and sociodemographic variables.
MATERIALS AND METHODS: A population-based retrospective cohort study of the Surveillance Epidemiology and End Results database (1998-2016) was performed. Univariate and multivariate logistic regression modeling evaluated the association of race and US census-reported sociodemographic factors with Mohs micrographic surgery (MMS) utilization.
RESULTS: A total of 76,328 adult patients with head and neck MIS/LM were included. MMS accounted for 11.8% of total cases, with increased utilization observed since 1998-2002. Compared with areas with greater percentages of individuals completing high school (first quartile), patients living in the second (Odds ratio [OR] 0.71; 95% confidence interval [CI] 0.64-0.80; p < .001), third (OR 0.74; 95% CI 0.63-0.86; p < .001), and fourth quartiles (OR 0.44; 95% CI 0.35-0.55; p < .001) were less likely to undergo MMS for their MIS/LM.
CONCLUSION: Educational efforts and awareness can bridge the knowledge gaps of appropriate treatment in patients with head and neck MIS/LM.
OBJECTIVE: To characterize treatment differences for head and neck melanoma in situ (MIS) and lentigo maligna (LM) based on race and sociodemographic variables.
MATERIALS AND METHODS: A population-based retrospective cohort study of the Surveillance Epidemiology and End Results database (1998-2016) was performed. Univariate and multivariate logistic regression modeling evaluated the association of race and US census-reported sociodemographic factors with Mohs micrographic surgery (MMS) utilization.
RESULTS: A total of 76,328 adult patients with head and neck MIS/LM were included. MMS accounted for 11.8% of total cases, with increased utilization observed since 1998-2002. Compared with areas with greater percentages of individuals completing high school (first quartile), patients living in the second (Odds ratio [OR] 0.71; 95% confidence interval [CI] 0.64-0.80; p < .001), third (OR 0.74; 95% CI 0.63-0.86; p < .001), and fourth quartiles (OR 0.44; 95% CI 0.35-0.55; p < .001) were less likely to undergo MMS for their MIS/LM.
CONCLUSION: Educational efforts and awareness can bridge the knowledge gaps of appropriate treatment in patients with head and neck MIS/LM.