Health Disparities Influence Childhood Melanoma Stage at Diagnosis and Outcome

Emma C. Hamilton; Hoang T. Nguyen; Yu-Chia Chang; Jan M. Eberth; Janice Cormier; Linda S. Elting; Mary T. Austin

doi:10.1016/j.jpeds.2016.04.068

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Health Disparities Influence Childhood Melanoma Stage at Diagnosis and Outcome

Journal article

Open access

Peer reviewed

Health Disparities Influence Childhood Melanoma Stage at Diagnosis and Outcome

Emma C. Hamilton, Hoang T. Nguyen, Yu-Chia Chang, Jan M. Eberth, Janice Cormier, Linda S. Elting and Mary T. Austin

The Journal of pediatrics, v 175, pp 182-187

01 Aug 2016

DOI: https://doi.org/10.1016/j.jpeds.2016.04.068

PMID: 27233520

Featured in Collection : UN Sustainable Development Goals @ Drexel

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Abstract

health services research

pediatric melanoma

racial disparities

socioeconomic status

To identify health disparities in pediatric patients with melanoma that affect disease presentation and outcome. This was a retrospective cohort study of all persons aged ≤18 years diagnosed with melanoma and enrolled in the Texas Cancer Registry between 1995 and 2009. Socioeconomic status (SES) and driving distance to the nearest pediatric cancer treatment center were calculated for each patient. Logistic regression was used to determine factors associated with advanced-stage disease. Life table methods and Cox regression were used to estimate survival probability and hazard ratios. A total of 185 adolescents (age >10 years) and 50 young children (age ≤10 years) were identified. Hispanics (n = 27; 12%) were 3 times more likely than non-Hispanic whites (n = 177; 75%) to present with advanced disease (OR, 3.8; 95% CI, 1.7-8.8). Young children were twice as likely as adolescents to present with advanced disease (OR, 2.2; 95% CI, 1.1-4.3). Distance to treatment center and SES did not affect stage of disease at presentation. Hispanics and those in the lowest SES quartile had a significantly higher mortality risk (hazard ratios, 3.0 [95% CI, 1.2-7.8] and 4.3 [95% CI, 1.4-13.9], respectively). In the adjusted survival model, only advanced disease was predictive of mortality (P < .001). Hispanics and young children with melanoma are more likely to present with advanced disease, and advanced disease is the single most important predictor of survival. Heightened awareness among physicians is needed to facilitate early detection of melanoma within these groups.

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Details

Title: Health Disparities Influence Childhood Melanoma Stage at Diagnosis and Outcome
Creators: Emma C. Hamilton - The University of Texas Health Science Center at Houston
Hoang T. Nguyen - The University of Texas MD Anderson Cancer Center
Yu-Chia Chang - Department of Health Services Research, The University of Texas M.D. Anderson Cancer Center, Houston, TX
Jan M. Eberth - University of South Carolina
Janice Cormier - The University of Texas MD Anderson Cancer Center
Linda S. Elting - The University of Texas MD Anderson Cancer Center
Mary T. Austin - The University of Texas MD Anderson Cancer Center
Publication Details: The Journal of pediatrics, v 175, pp 182-187
Publisher: Elsevier
Grant note: RP101207 / Cancer Prevention Research Institute of Texas (http://dx.doi.org/10.13039/100004917)
Resource Type: Journal article
Language: English
Academic Unit: Health Management and Policy
Web of Science ID: WOS:000380835500036
Scopus ID: 2-s2.0-84971631316
Other Identifier: 991021855182204721

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Collaboration types: Domestic collaboration
Web of Science research areas: Pediatrics