Disparities in the presentation and management of cutaneous melanoma that required admission

Abstract

Objective: In this study, we aimed to examine the association of demographic and socioeconomic factors with cutaneous melanoma that required admission. Methods: A cross-sectional study utilizing the Nationwide Inpatient Sample database, 2003-2009, was merged with County Health Rankings Data. Results: A total of 2,765 discharge -records were included. Men were more likely to have melanoma in the head, neck, and trunk regions (p < 0.001), while extremities melanoma was more common in women (p < 0.001). Males had a higher risk of lymph node metastasis on presentation (OR 1.54, 95% CI [1.27-1.89]). Blacks and Hispanics were more likely to present with extremities melanoma. Patients with low annual income were more likely to be treated by low-volume surgeons and in hospitals located in high-risk communities (p < 0.05 each). Patients with Medicaid coverage were twice as likely to present with distant metastasis and were more likely to be managed by low-volume surgeons (p < 0.05 each). Conclusions: The presentation and outcomes of cutaneous melanoma have a distinct pattern of distribution based on patients' characteristics.