Persistent poverty and incidence-based melanoma mortality in Texas

• Published in: Cancer causes & control Vol. 35; no. 6; pp. 973 - 979
• Main Authors: Madrigal, Karla, Morris, Lillian, Zhang, Kehe, Nelson, Emelie, Tran, Tiffaney, Galindez, Marcita, Duan, Zhigang, Adamson, Adewole S., Zhao, Hui, Doan, Hung Q., Taylor, Madison M., Bauer, Cici, Nelson, Kelly C.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.06.2024; Springer Nature B.V
• Subjects: Adult; Aged; Biomedical and Life Sciences; Biomedicine; Brief Report; Cancer; Cancer Research; Demographic variables; Diagnosis; Epidemiology; Female; Hematology; Humans; Incidence; Male; Melanoma; Melanoma - epidemiology; Melanoma - mortality; Middle Aged; Mortality; Oncology; Poverty; Poverty - statistics & numerical data; Public Health; Registries; Skin Neoplasms - epidemiology; Skin Neoplasms - mortality; Statistical analysis; Texas - epidemiology; Young Adult; Texas; United States > US; Incidence-based mortality; Secondary prevention; Healthcare disparities; Texas Cancer Registry; Cutaneous melanoma; Persistent poverty
• ISSN: 0957-5243; 1573-7225
• DOI: 10.1007/s10552-023-01841-5

Purpose Previous studies have shown that individuals living in areas with persistent poverty (PP) experience worse cancer outcomes compared to those living in areas with transient or no persistent poverty (nPP). The association between PP and melanoma outcomes remains unexplored. We hypothesized that melanoma patients living in PP counties (defined as counties with ≥ 20% of residents living at or below the federal poverty level for the past two decennial censuses) would exhibit higher rates of incidence-based melanoma mortality (IMM). Methods We used Texas Cancer Registry data to identify the patients diagnosed with invasive melanoma or melanoma in situ (stages 0 through 4) between 2000 and 2018 ( n  = 82,458). Each patient’s PP status was determined by their county of residence at the time of diagnosis. Results After adjusting for demographic variables, logistic regression analyses revealed that melanoma patients in PP counties had statistically significant higher IMM compared to those in nPP counties (17.4% versus 11.3%) with an adjusted odds ratio of 1.35 (95% CI 1.25–1.47). Conclusion These findings highlight the relationship between persistent poverty and incidence-based melanoma mortality rates, revealing that melanoma patients residing in counties with persistent poverty have higher melanoma-specific mortality compared to those residing in counties with transient or no poverty. This study further emphasizes the importance of considering area-specific socioeconomic characteristics when implementing place-based interventions to facilitate early melanoma diagnosis and improve melanoma treatment outcomes.