The expanding melanoma burden in California hispanics: Importance of socioeconomic distribution, histologic subtype, and anatomic location.
The expanding melanoma burden in California hispanics: Importance of socioeconomic distribution, histologic subtype, and anatomic location.
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DOI：
10.1002/cncr.25355
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发表时间：
2011-01-01
期刊：
影响因子：
6.2
通讯作者：
Cockburn, Myles
中科院分区：
文献类型：
--
作者：
Pollitt, Ricardo A.;Clarke, Christina A.;Swetter, Susan M.;Peng, David H.;Zadnick, John;Cockburn, Myles
西班牙裔皮肤黑色素瘤的发病模式和社会经济分布知之甚少。我们获得了加州州1988-2007年诊断为侵袭性皮肤黑色素瘤的所有西班牙裔和非西班牙裔白色（NHW）患者的基于人群的发病率数据。使用社区水平的社会经济状况（SES）指标，我们调查了SES分类组诊断时较厚（> 2 mm）与较薄（≤ 2 mm）肿瘤的发病率、厚度、组织学亚型和解剖部位以及相对风险（RR）。非卫生工作者中每百万人的经病理学校正的黑色素瘤发病率较高（P <.0001）;西班牙裔美国人诊断时的肿瘤厚度较大（P <.0001）。61%的NHW黑色素瘤发生在高SES组。在西班牙裔美国人中，只有35%发生在高SES组; 22%是低SES。较低的SES与较厚的肿瘤相关（P <0.0001）;这种关联在西班牙裔中更强。低SES与高SES NHW男性中较厚与较薄（≤ 2 mm）肿瘤的相对风险（RR）为1.48（95% CI，1.37-1.61）;西班牙裔男性为2.18（95% CI，1.73-2.74）。低SES患者的浅表扩散性黑色素瘤亚型较少（尤其是西班牙裔男性），结节性黑色素瘤亚型较多。腿部/臀部黑色素瘤与NHW男性的较高SES相关，但与西班牙裔男性的较低SES相关。黑色素瘤发病率和肿瘤厚度的社会经济分布在西班牙裔和NHW加利福尼亚州人之间差异很大，特别是在男性之间。黑色素瘤的预防工作针对较低的SES西班牙裔和提高医生对黑色素瘤模式的认识西班牙裔是必要的。
The incidence patterns and socioeconomic distribution of cutaneous melanoma among Hispanics are poorly understood. We obtained population-based incidence data for all Hispanic and Non-Hispanic White (NHW) patients diagnosed with invasive cutaneous melanoma from 1988-2007 in the state of California. Using a neighborhood-level measure of socioeconomic status (SES), we investigated incidence, thickness at diagnosis, histologic subtype, and anatomic site and the relative risk (RR) for thicker (>2mm) versus thinner (≤2mm) tumors at diagnosis for groups categorized by SES. Age-adjusted melanoma incidence rates per million were higher in NHWs (P <.0001); tumor thickness at diagnosis was greater in Hispanics (P <.0001). Sixty-one percent of melanomas in NHWs occurred in the High SES group. Among Hispanics, only 35% occurred in the High SES group; 22% were of Low SES. Lower SES was associated with thicker tumors (P <.0001); this association was stronger in Hispanics. The relative risk (RR) for thicker versus thinner (≤2mm) tumors in Low-SES versus High-SES NHW men was 1.48 (95% CI, 1.37-1.61); it was 2.18 (95% CI, 1.73-2.74) in Hispanic men. Lower-SES patients had less superficial spreading melanoma subtype (especially among Hispanic men) and more nodular melanoma subtype. Leg/hip melanomas were associated with higher SES in NHW males but with lower SES in Hispanic males. The socioeconomic distribution of melanoma incidence and tumor thickness differed substantially between Hispanic and NHW Californians, particularly among males. Melanoma prevention efforts targeted to lower-SES Hispanics and increased physician awareness of melanoma patterns among Hispanics are needed.
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