12362 Faculty of Medicine, Michael G. DeGroote School of Medicine, Hamilton, ON, Canada.
2129 Faculty of Science, University of Calgary, AB, Canada.
J Cutan Med Surg. 2022 Mar-Apr;26(2):181-188. doi: 10.1177/12034754211052866. Epub 2021 Oct 22.
Factors influencing the difference in the diagnosis and treatment of melanoma in racial minority groups are well-described in the literature and include atypical presentations and socioeconomic factors that impede access to care.
To characterize the differences in melanoma survival outcomes between non-Hispanic white patients and ethnic minority patients in North America.
We conducted searches of Embase via Ovid and MEDLINE via Ovid of studies published from 1989 to August 5, 2020. We included observational studies in North America which reported crude or effect estimate data on patient survival with cutaneous melanoma stratified by race.
Forty-four studies met our inclusion criteria and were included in this systematic review. Pooled analysis revealed that black patients were at a significantly increased risk for overall mortality (HR 1.42, 95% CI, 1.25-1.60), as well as for melanoma-specific mortality (HR 1.27, 95% CI, 1.03-1.56). Pooled analyses using a representative study for each database yielded similar trends. Other ethnic minorities were also more likely report lower melanoma-specific survival compared to non-Hispanic white patients.
Our results support findings that melanoma patients of ethnic minorities, particularly black patients, experience worse health outcomes with regards to mortality. Overall survival and melanoma-specific survival are significantly decreased in black patients compared to non-Hispanic white patients. With the advent of more effective, contemporary treatments such as immunotherapy, our review identifies a gap in the literature investigating present-day or prospective data on melanoma outcomes, in order to characterize how current racial differences compare to findings from previous decades.
文献中充分描述了影响少数族裔群体中黑色素瘤诊断和治疗差异的因素，包括不典型表现和社会经济因素，这些因素阻碍了获得医疗的机会。
描述北美非西班牙裔白人和少数民族患者之间黑色素瘤生存结果的差异。
我们通过 Ovid 对 Embase 进行了检索，并通过 Ovid 对 MEDLINE 进行了检索，检索了 1989 年至 2020 年 8 月 5 日发表的研究。我们纳入了在北美进行的观察性研究，这些研究报告了根据种族分层的皮肤黑色素瘤患者的生存粗率或效应估计数据。
44 项研究符合我们的纳入标准，并被纳入本系统评价。汇总分析显示，黑人患者的总死亡率（HR 1.42，95%CI，1.25-1.60）和黑色素瘤特异性死亡率（HR 1.27，95%CI，1.03-1.56）显著升高。使用每个数据库的代表性研究进行的汇总分析得出了类似的趋势。与非西班牙裔白人患者相比，其他少数民族患者也更有可能报告黑色素瘤特异性生存率较低。
我们的研究结果支持这样的发现，即少数族裔黑色素瘤患者，特别是黑人患者，在死亡率方面的健康结果更差。与非西班牙裔白人患者相比，黑人患者的总生存率和黑色素瘤特异性生存率显著降低。随着更有效、更现代的治疗方法（如免疫疗法）的出现，我们的综述确定了一个文献空白，即调查当前或前瞻性黑色素瘤结果数据，以描述当前的种族差异与前几十年的研究结果相比如何。
