Bernice Yan, MD: How Race and Socioeconomic Status Influence ALM Survival Rates

Bernice Yan, MD

A new investigation out of New York found that race and socioeconomic status negatively influenced the survival rate for people with acral lentiginous melanoma.

The research, which was published in the Journal of the American Academy of Dermatology, evaluated a total of 2245 patients with ALM and observed that patients from the lowest socioeconomic category were approximately 3 times more likely to present with Stage IV disease at the time of diagnosis.

Additionally, Hispanic white patients (69.7%) and Black patients (70%) had lower survival rates when compared to non-Hispanic white patients (80.4%).

In an interview with HCPLive, Bernice Yan, MD, Feinstein Institutes for Medical Research at Northwell Health, Manhasset, New York, spoke of how economic status and race may have accounted for the difference in ALM survival rates.

“Race and socioeconomic status are parts of the equation that make up social determinants of health, which contribute to disparate health outcomes,” Yan said. “Worse survival outcomes in ALM in patients with skin of color and lower socioeconomic status may be related to a number of factors, including decreased awareness of the clinical signs of acral melanoma, barriers to accessing care, and delays in diagnosis.”

She added that acral melanoma is the most common subtype of melanoma in patients with skin of color and the least common subtype in white patients, and noted the important for patients with skin of color to monitor moles that are on their hands and feet, especially on palms, soles and other areas that are more difficult to monitor.

Though patients could take preventive measures that include being mindful of any discoloration, growth, or changes within and around fingernails and toenails, Yan believed the study also highlighted the need for increased public awareness and an understanding of the social barriers that keep patients with skin of color from receiving appropriate and timely care.

“Increased public awareness, among both patients and health care providers, is essential for earlier detection of melanoma,” Yan said. “By raising awareness of racial and socioeconomic factors affecting survival in acral melanoma, our study lays the foundation for additional research and public health efforts in the future. Additional studies are needed to unveil the mechanisms underlying these disparate health outcomes and the impact that various interventions may have in leading to earlier detection and improving survival outcomes in melanoma.”