School of Medicine, Case Western Reserve University, Cleveland, Ohio.
Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio.
J Am Acad Dermatol. 2023 Sep;89(3):529-536. doi: 10.1016/j.jaad.2023.05.028. Epub 2023 May 22.
Asian American and Pacific Islander (AAPI) melanoma patients have higher mortality than non-Hispanic White (NHW) patients. Treatment delays may contribute, but whether AAPI patients have longer time from diagnosis to definitive surgery (TTDS) is unknown.
Investigate TTDS differences between AAPI and NHW melanoma patients.
Retrospective review of AAPI and NHW melanoma patients in the National Cancer Database (NCD) (2004-2020). The association of race with TTDS was evaluated by multivariable logistic regression, controlling for sociodemographic characteristics.
Of 354,943 AAPI and NHW melanoma patients identified, 1155 (0.33%) were AAPI. AAPI patients had longer TTDS for stage I, II, and III melanoma (P < .05 for all). Adjusting for sociodemographic factors, AAPI patients had 1.5 times the odds of a TTDS between 61 and 90 days and twice the odds of a TTDS >90 days. Racial differences in TTDS persisted in Medicare and private insurance types. Uninsured AAPI patients had the longest TTDS (mean, 53.26 days), while those with private insurance had the shortest TTDS (mean, 34.92 days; P < .001 for both).
AAPI patients comprised 0.33% of the sample.
AAPI melanoma patients have increased odds of treatment delays. Associated socioeconomic differences should inform efforts to reduce disparities in treatment and survival.
亚裔美国人和太平洋岛民（AAPI）黑色素瘤患者的死亡率高于非西班牙裔白人（NHW）患者。治疗延迟可能是原因之一，但 AAPI 患者从诊断到确定性手术（TTDS）的时间是否更长尚不清楚。
研究 AAPI 和 NHW 黑色素瘤患者 TTDS 的差异。
回顾性分析国家癌症数据库（NCD）（2004-2020 年）中 AAPI 和 NHW 黑色素瘤患者。通过多变量逻辑回归评估种族与 TTDS 的关联，同时控制社会人口统计学特征。
在 354943 名 AAPI 和 NHW 黑色素瘤患者中，有 1155 名（0.33%）为 AAPI。AAPI 患者的 I 期、II 期和 III 期黑色素瘤 TTDS 较长（所有 P<0.05）。调整社会人口统计学因素后，AAPI 患者 TTDS 在 61-90 天和 TTDS>90 天的可能性是对照组的 1.5 倍和 2 倍。在医疗保险和私人保险类型中，TTDS 的种族差异仍然存在。未参保的 AAPI 患者 TTDS 最长（平均 53.26 天），而私人保险患者 TTDS 最短（平均 34.92 天；两者均 P<0.001）。
AAPI 患者仅占样本的 0.33%。
AAPI 黑色素瘤患者治疗延迟的可能性增加。相关的社会经济差异应告知努力减少治疗和生存方面的差异。
