Journal of the American Academy of Dermatology · 2019
Factors associated with time to surgery in melanoma: An analysis of the National Cancer Database.
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Baranowski Marissa L H, Yeung Howa, Chen Suephy C, Gillespie Theresa W, Goodman Michael
Аннотация
BACKGROUND: Timely treatment for melanoma may affect survival, and characterizing the predictors of delay may inform intervention strategies.
OBJECTIVE: To determine characteristics associated with the interval between diagnosis and surgery in melanoma.
METHODS: The National Cancer Database was used to examine factors associated with the interval between diagnosis and surgery among 213 146 patients with stage I, II, or III cutaneous melanoma.
RESULTS: Among privately insured patients, time to surgery was longer for patients aged 50 to 70 years (hazard ratio [HR], 0.96) and older than 70 years (HR, 0.83) compared with those younger than 50 years. In contrast, patients without private insurance experienced a shorter surgical wait time if older (HR for age 50-70 years, 1.07; HR for age >70 years, 1.05). Other factors associated with longer surgical interval included nonwhite race, less education, higher comorbidity burden, advanced stage, and head or neck melanoma location.
LIMITATIONS: Use of zip code-level data for income and education level.
CONCLUSION: Patients with melanoma experience disparities in timely receipt of surgery.
OBJECTIVE: To determine characteristics associated with the interval between diagnosis and surgery in melanoma.
METHODS: The National Cancer Database was used to examine factors associated with the interval between diagnosis and surgery among 213 146 patients with stage I, II, or III cutaneous melanoma.
RESULTS: Among privately insured patients, time to surgery was longer for patients aged 50 to 70 years (hazard ratio [HR], 0.96) and older than 70 years (HR, 0.83) compared with those younger than 50 years. In contrast, patients without private insurance experienced a shorter surgical wait time if older (HR for age 50-70 years, 1.07; HR for age >70 years, 1.05). Other factors associated with longer surgical interval included nonwhite race, less education, higher comorbidity burden, advanced stage, and head or neck melanoma location.
LIMITATIONS: Use of zip code-level data for income and education level.
CONCLUSION: Patients with melanoma experience disparities in timely receipt of surgery.