Disparities in the Presentation and Management of Cutaneous Melanoma That Required Admission.

OBJECTIVE

In this study, we aimed to examine the association of demographic and socioeconomic factors with cutaneous melanoma that required admission.

METHODS

A cross-sectional study utilizing the Nationwide Inpatient Sample database, 2003-2009, was merged with County Health Rankings Data.

RESULTS

A total of 2,765 discharge -records were included. Men were more likely to have melanoma in the head, neck, and trunk regions (p < 0.001), while extremities melanoma was more common in women (p < 0.001). Males had a higher risk of lymph node metastasis on presentation (OR 1.54, 95% CI [1.27-1.89]). Blacks and Hispanics were more likely to present with extremities melanoma. Patients with low annual income were more likely to be treated by low-volume surgeons and in hospitals located in high-risk communities (p < 0.05 each). Patients with Medicaid coverage were twice as likely to present with distant metastasis and were more likely to be managed by low-volume surgeons (p < 0.05 each).

CONCLUSIONS

The presentation and outcomes of cutaneous melanoma have a distinct pattern of distribution based on patients' characteristics.