Last Updated: 2006-06-30 10:30:03 -0400 (Reuters Health)
NEW YORK (Reuters Health) - A retrospective analysis of melanoma patients in Dade County, Florida, shows that late-stage diagnosis was more common at first presentation for black and Hispanic patients than for non-Hispanic white patients.
Dr. Robert S. Kirsner and colleagues at the University of Miami Miller School of Medicine studied 1,690 cases of melanoma reported between 1997 and 2002. Seventy percent were non-Hispanic whites, 29% were Hispanics and 2% were black patients.
Late-stage disease, both regional and distant, was most common in Hispanics, occurring in 26%. Late-stage disease was found at first presentation in 52% of blacks and in 16% of non-Hispanic whites.
"There are two broad possibilities for this," Dr. Kirsner told Reuters Health. "The first possibility could be the nature of the disease, with faster, more aggressive disease in non-whites than whites, but there no evidence for that."
"The other more likely possibility is a lack of education among patients and physicians," Dr. Kirsner said. "Patients at high risk are known to lack education about the disease and to engage in fewer self-protective behaviors, such as putting on sunscreen and staying out of the bright sun...Dark-skinned patients often don't realize they are at risk of melanoma."
"The public health message has not been aimed at these patients," Dr. Kirsner said. "And when there is limited access to healthcare, issues are prioritized, and this is one that is often just not addressed."
Dr. Kirsner said that physicians, as well, lack education as to melanoma in general, and for dark-skinned patients in particular.
"There is evidence that about a third or fewer physicians perform a full-body skin exam on their patients, and only 50% of high-risk patients receive such an examination," he noted.
His study is published in the June issue of the Archives of Dermatology.
Arch Dermatol 2006;142:704-708.
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