Demographic and socioeconomic predictors of melanoma prognosis in the United States.

Studies suggest sociodemographic factors may influence melanoma prognosis. Our objective was to quantify sociodemographic predictors of U.S. melanoma. Data from 17,702 melanoma cases reported to the Surveillance Epidemiology and End Results (SEER) program from 1988-1993 were merged with sociodemographic data (1990 U.S. Census). Regression analysis was used to model prognosis: melanoma mortality to incidence ratio. Prognosis was significantly associated with neighborhood racial heterogeneity, education and income. Melanoma patients who resided in areas with higher education (OR 0.4, 95% CI 0.3-0.5), more White residents (OR 0.7, 95% CI 0.5-0.8), or higher incomes (OR 0.4, 95% CI 0.2-0.5) were less likely to have poor prognosis. Education explained 3.3 times more variance than race and 1.9 times more than income. Sociodemographic factors were associated with stage and tumor thickness. Neighborhood sociodemographic variables were predictive of melanoma prognosis, and suggest an important direction for targeting public health efforts to reach those in at-risk communities.