4.6 Article

The impact of demographics, socioeconomics, and health care access on melanoma outcomes

期刊

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY
卷 84, 期 6, 页码 1677-1683

出版社

MOSBY-ELSEVIER
DOI: 10.1016/j.jaad.2020.07.125

关键词

access; ethnicity; health disparities; insurance; melanoma; outcomes; race

资金

  1. University of California, San Francisco Department of Dermatology Summer Research Fellowship
  2. Helen Diller Family Comprehensive Cancer Care Impact Grant

向作者/读者索取更多资源

Melanoma care in the United States faces disparities in providers, patient demographics, residence, insurance, socioeconomic factors, race/ethnicity, and age, impacting outcomes. Melanomas detected by dermatologists tend to be thinner, at an earlier stage, and have better survival rates. Lower socioeconomic status, race/ethnicity, and residence can lead to late-stage melanomas with worse outcomes.
Disparities in melanoma care exist in the United States. Disparities in provider type, patient demographics, place of residence, insurance status, socioeconomic status, race/ethnicity, and age impact melanoma outcomes. Melanomas detected by dermatologists are thinner, at an earlier stage, and have better survival outcomes compared with detection by primary care providers or patients. Lower socioeconomic status, race/ethnicity, and place of residence are associated with decreased access to or use of dermatologists, or both, and more advanced melanomas at diagnosis. Additionally, uninsured and publicly insured individuals are more likely to present with late-stage melanomas, resulting in worse outcomes. This review provides a comprehensive overview of how structural and patient-level characteristics influence melanoma outcomes in order to inform clinical care and health care policy as it relates to addressing gaps in melanoma care.

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