Shades of evidence: a review of skin color reporting in melanoma-related randomized controlled trials.

OBJECTIVES

To examine the rate of skin color reporting in randomized controlled trials (RCTs) involving melanoma in the top ten highest dermatology journals by impact factor over the past four decades.

METHODS

A systematic review of RCTs involving melanoma within the top ten dermatology journals, as determined by impact factor, was conducted from inception to July 10th, 2023. Studies were included if they reviewed the diagnosis and/or treatment of melanoma, were RCTs, directly involved patients and were written in English. Studies were characterized as positive for reporting skin of color (SOC) if the demographic data in the results or methods sections included any of the following: race, ethnicity, skin of color, Fitzpatrick scale, sunburn tendency, phototype, skin type, or skin tone.

RESULTS

Out of 76 studies initially identified, only 49 articles met inclusion criteria. Of these 49 articles, only 24 articles recorded data of skin color from their demographics (49%). Subgroup analysis showed no statistically significant difference in the rate of reporting between studies grouped by decade (p = 0.779) or by study location (p = 0.763).

CONCLUSION

Darker skin tones can disguise melanotic skin lesions. Less than 50% of RCTs related to melanoma in the top ten international dermatology journals included skin color within their results section to characterize study participants. This has a negative impact on our understanding of this potentially devastating disease.