Melanoma in African-Americans: Trends in biological behavior and clinical characteristics over two decades

Background: The incidence of melanoma in the United States is increasing. Data on this disease in African-Americans is sparse. Methods: Chart review Of patients diagnozed with melanoma from 1975 to 1997 at Charity Hospital New Orleans (CHNO). Age, gender, anatomic distribution. histology, presenting stage, survival, and race were evaluated. Results: Forty-four of 198 patients were African-American, of whom the majority developed cutaneous melanoma on the acral surface of the foot. African-American males were four times more likely to present with a cutaneous lesion than were African-American females. The median survival time for African-American with cutaneous lesions was 45 months, compared to 135 months for caucasians who were 3.6 times more likely to present with early disease (P < 0.05). TNM stage at presentation, and ulceration were significant, independent factors associated with a worse outcome in African-Americans. Conclusion: Overall survival time for African-Americans with cutaneous melanoma is significantly shorter than for caucasians with this disease. This trend may be attributable to the fact that African-Americans present with advanced disease. An increased level of awareness among both patients and health-care providers is necessary to identify African-Americans with melanoma at earlier stages of disease and to improve survival. (C) 2001 Wiley-Liss, Inc.