Melanoma in African-Americans: trends in biological behavior and clinical characteristics over two decades.

BACKGROUND

The incidence of melanoma in the United States is increasing. Data on this disease in African-Americans is sparse.

METHODS

Chart review of patients diagnozed with melanoma from 1975 to 1997 at Charity Hospital New Orleans (CHNO). Age, gender, anatomic distribution, histology, presenting stage, survival, and race were evaluated.

RESULTS

Forty-four of 198 patients were African-American, of whom the majority developed cutaneous melanoma on the acral surface of the foot. African-American males were four times more likely to present with a cutaneous lesion than were African-American females. The median survival time for African-American with cutaneous lesions was 45 months, compared to 135 months for caucasians who were 3.6 times more likely to present with early disease (P < 0.05). TNM stage at presentation, and ulceration were significant, independent factors associated with a worse outcome in African-Americans.

CONCLUSION

Overall survival time for African-Americans with cutaneous melanoma is significantly shorter than for caucasians with this disease. This trend may be attributable to the fact that African-Americans present with advanced disease. An increased level of awareness among both patients and health-care providers is necessary to identify African-Americans with melanoma at earlier stages of disease and to improve survival.