A recent study published in the Journal of the American Academy of Dermatology has shed light on the alarming disparities in melanoma outcomes among different racial and ethnic groups, particularly highlighting the heightened risks Black men faced despite being less susceptible to the disease.
The study, conducted by a team of scientists, delved into data encompassing more than 205,000 men diagnosed with melanoma between 2004 and 2018. Astonishingly, the findings uncovered a glaring contrast in survival rates among various racial and ethnic categories. The five-year survival rate was notably lowest for Black men, hovering around 52 percent, while it was significantly higher for white men, at approximately 75 percent.
This startling discrepancy translates into a staggering 26 percent higher risk of death for Black men compared to their white counterparts.
Dermatologist Ali Hendi, MD, skin cancer surgeon, and clinical assistant professor at Georgetown University Hospital in Washington, DC, who wasn’t involved in the study said, “This is likely due to the fact that melanoma in Black men is far less likely than in white men.”
“For this reason, it is not on the radar of physicians and patients alike,” Dr. Hendi says.
Melanoma Outcomes for All Men of Color Lag Behind Those of White Men
In the United States, melanoma incidence rates have shown a strong correlation with race and gender. White men are particularly susceptible to this form of skin cancer, whereas Black women have exhibited the lowest incidence rates, according to the Centers for Disease Control and Prevention (CDC).
The study’s comprehensive examination of melanoma outcomes revealed significant differences among racial groups. Five-year survival rates for melanoma stood at 66 percent for Hispanic men, 68 percent for Asian men, and 69 percent for American Indian/Alaskan Native men, all of which lagged behind the survival rate of white men.
Furthermore, the research unveiled distinctions in the location of melanoma development on the body. White and American Indian/Alaskan Native men were more likely to have these tumors on their body trunks, typically exposed to the sun.
In contrast, Black, Hispanic, and Asian men showed a higher tendency to have melanoma diagnosed on their lower extremities, which receive less sun exposure, or in usual locations such as the skin between fingers or toes.
Additionally, the study uncovered a concerning trend where Black, Hispanic, and Asian men were more likely to receive a melanoma diagnosis when the cancer was in its advanced stages, making it harder to treat effectively.
“It is widely known in our speciality that, although less common, minorities are often diagnosed at a later stage when they get melanoma. Access to care may play a role,” says Dr. Hendi.
Black Men Face Higher Risks of Melanoma Even When Diagnosed Early
While this study wasn’t a controlled experiment aimed at establishing direct causality between race and melanoma outcomes, it raised critical questions about the potential influence of factors. These included healthcare access and social or cultural attitudes toward skin protection and cancer screening.
Dr. Robert Brodell, a professor and chair of pathology at the University of Mississippi Medical Center, who was not involved with the study, emphasized that even when melanoma was diagnosed at the same stage, Black men exhibited worse outcomes than white men. This implies that factors beyond the disease itself may be at play, prompting the need for a deeper understanding of these disparities.
One factor that could contribute to these disparities is the nature of melanoma itself. White individuals tend to develop melanoma types attributed to sun exposure, often characterized by horizontal growth across the skin’s surface, making them relatively easier to detect and treat before they spread, explains Dr. Brodell.
“The kind of melanoma that is found in Black patients may have a uniquely worse prognosis than the common kind found in white people. And even when Black men get melanoma that should be easier to spot and treat earlier, dark discoloration that’s a hallmark of early-stage melanoma may not be as visible on Black skin,” Brodell adds.
Here Are the Signs of Skin Cancer
While universal skin cancer screening isn’t recommended in the United States, the U.S. Preventive Services Task Force – people with unexplained discolorations on their skin or a history of precancerous spots – should get regular skin checks.
In addition, the American Academy of Dermatology recommends self-skin exams to look for melanoma and offers the following “ABCDE” tips for people to identify changes on the skin that need to be checked by a doctor. They are as follows:
- AsymmetryOne half of the spot is unlike the other half.
- Border The spot has an irregular, scalloped, or poorly defined border.
- Color The spot has varying colors from one area to the next, such as shades of tan, brown, or black, or areas of white, red, or blue.
- Diameter Melanomas are usually greater than 6 millimeters, or about the size of a pencil eraser.
- Evolving The spot looks different from the rest or is changing in size, shape, or color.
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