Although melanoma is much more common in white men, studies have shown that black men are 26 percent more likely to die from the disease. Only about 2.5 percent of the more than 200,000 men studied were black, yet their survival rate was much lower than that of white men.
“I think it’s important,” said Ali Hendy, a skin cancer surgery specialist in Chevy Chase, Md., who was not involved in the study. “The study doesn’t answer why, but the numbers do.”
The study was released Tuesday. Journal of the American Academy of Dermatologythe following trends were found:
- 48.6 percent of black men with melanoma are diagnosed at the late stage of the disease, which is more difficult to treat, compared to 21.1 percent of white men. Terminal diagnosis occurs in 39.6 percent of Hispanic men, 37.6 percent of Asian men, and 29.1 percent of Native American men. If detected early, The 5-year survival rate for melanoma is 99 percent. However, if diagnosis is delayed, the odds change dramatically. When melanoma spreads to distant parts of the body, the 5-year relative survival rates are: about 32 percent.
- The location of melanoma on the body varies greatly between races. Data show that 50.7 percent of black men with melanoma have melanoma. on the lower extremities. He was less than 10 percent of white men with the disease in his lower extremities. For Caucasian men, most cases were torso (35.5%) or head and neck (25.7%). By comparison, in black men, only 12.6% of cases occurred on the torso and 9.8% on the head.
- Melanoma in black men is more common in areas that are not normally exposed to the sun, such as the soles of the feet, toes, toenails, fingers, nail beds, and palms of the hands.
- More than 75 percent of white men survive five years or more after being diagnosed with melanoma. Only 51.7 percent of black men do.
Jeremy Brauer, an internist and clinical associate professor of dermatology at New York University Langone Health, said the study is a public health warning to doctors and patients about melanoma, even in black patients, who rarely develop melanoma. Underscoring the importance of increasing education, said Jeremy Brauer, a physician and clinical associate professor of dermatology at New York University Langone Health. to the study.
Brauer said doctors are often trained to identify skin cancer in fair skin and may not know how the disease manifests differently in different races.
“This disproportionate and disappointing mortality rate means we must do more to prevent it,” Brauer said.
More deadly melanoma
Investigators in this study compared diagnostic data from the National Cancer Database from 2004 to 2018 in white, black, Asian, Native American/Alaska Native, and Hispanic men.
“Our study aimed to delve deeper into why we see these differences in survival and the factors that may be causing them,” said co-author, University of Nebraska Medical Center. said Ashley Wyson, a physician and director of dermatology at
Nearly 1 in 5 people with black melanoma have one of the following subtypes: acral lentiginous melanomais a more deadly disease. By comparison, he was less than 1% of white men with this subtype.
“It has nothing to do with sun exposure,” said Robert Brodel, professor of pathology and dermatology at the University of Mississippi Medical Center, who was not involved in the study. “It appears to have a different natural history and a poor prognosis, partly due to delayed diagnosis.”
often appears as black dots under nails It’s growing or changing, Braudel said.
Wyson said melanoma on the fingers, toes, palms and soles is often mistaken for warts, fungi and other benign conditions and is ignored by patients. “They may look like flat, pink, gray, brown, or black lesions.”
“Most people don’t think they have skin cancer on their nails or hands or feet,” says Wyson. “So there’s a delay in diagnosis because of the location. It’s hard to see. Most people don’t know what nail melanoma looks like.”
Delayed diagnosis and other factors
Delayed diagnosis only partially explains why melanoma has a higher fatality rate in black men. Although the study adjusted for factors such as income, insurance, access to health care, and level of education, these variables “do not fully explain why black men have a 26 percent higher mortality rate than whites. ‘ said Wyson. “It suggests that biological factors are at work.”
David J. Reefel, professor of dermatology and surgery at Yale University School of Medicine and an expert in skin cancer and melanoma, said that hormonal differences could explain sex differences in melanoma among all men. said it was possible. He said the new study should bring much-needed attention to melanoma in black men.
“There is no focus on this issue, and if there is no focus, there is no research funding,” Leffel said. “So I think this article will draw some attention to the need to fund research in that area. And who knows? Pay more attention to the less common categories within melanoma. This may lead to a better understanding of melanoma in general.”
Invasive melanoma on the rise
The number of newly diagnosed cases of invasive melanoma each year has increased by 27% over the past decade. In 2023, he is expected to have 97,610 invasive melanoma diagnoses in the United States. Of those, 58,120 are men and 39,490 are women, according to the report. Skin Cancer Foundation. Also, 7,990 people are expected to die from melanoma this year, 5,420 of them men.
Dermatologists continue to emphasize strict sun protection, as the majority of melanoma results from sun damage to skin cells. Wyson said men tend to resist the very things that can save their lives, such as wearing hats, sunscreen, protective clothing, staying out of the sun, and seeing a dermatologist regularly. added.
Experts advise getting a skin check by a doctor once a year and a personal body check once a month. See your back and other low-visibility areas with the help of a partner or friend. Check the soles of your feet, palms of your hands, nail beds, and between your toes. You can also ask your barber or beautician to talk to you about any lesions or changes in your scalp.
If you notice anything new, changing, not healing, or bleeding, see a dermatologist.
“Melanoma is completely asymptomatic,” says Brodel. “As long as you don’t notice any changes in the mole, it’s nothing to worry about.”
