Harvey Valerie M, Patel Hitesh, Sandhu Sophia, Wallington Sherrie Flynt, Hinds Ginette
Department of Dermatology, Eastern Virginia Medical School, Norfolk, VA 23507, USA.
Cancer Control. 2014 Oct;21(4):343-9. doi: 10.1177/107327481402100411.
This article sought to elucidate how aspects of poverty and culture may contribute to race- and ethnicity-based disparities in cutaneous melanoma outcomes.
We identified published studies addressing the social determinants of melanoma. Selected review articles included US-based studies comprised of patients representing adults, children, and adolescents.
African Americans and Hispanics diagnosed with cutaneous melanoma are more likely to present with more advanced stages of disease at diagnosis and have higher rates of mortality than their nonminority counterparts. These disparities may be a consequence of economic, social, and cultural barriers such as low income, public forms of health insurance, lower levels of education, lower levels of melanoma awareness and knowledge, and lower rates of participation in melanoma screening. No studies in the literature examined the potential impact of social injustice, English proficiency, immigrant status, and health literacy.
Substantial gaps exist in our knowledge of the pathways linking social determinants and race- and ethnicity-based disparities in melanoma. More studies are warranted to inform the development of effective interventions aimed at narrowing inequities and improving cutaneous melanoma outcomes among minority populations.
本文旨在阐明贫困和文化因素如何导致皮肤黑色素瘤结局方面基于种族和族裔的差异。
我们检索了已发表的关于黑色素瘤社会决定因素的研究。入选的综述文章包括以美国为基础、涵盖成人、儿童和青少年患者的研究。
被诊断为皮肤黑色素瘤的非裔美国人和西班牙裔患者在确诊时更有可能处于疾病的更晚期阶段,且死亡率高于非少数族裔患者。这些差异可能是经济、社会和文化障碍造成的,如低收入、公共医疗保险形式、教育水平较低、黑色素瘤认知和知识水平较低以及黑色素瘤筛查参与率较低。文献中没有研究探讨社会不公、英语水平、移民身份和健康素养的潜在影响。
在我们对社会决定因素与黑色素瘤中基于种族和族裔的差异之间联系途径的认识方面存在重大差距。需要更多研究为制定有效干预措施提供依据,以缩小不平等现象并改善少数族裔人群的皮肤黑色素瘤结局。