This cross-sectional study analyzed geographic variation in demographic, socioeconomic, and clinical characteristics among U.S. patients diagnosed with melanoma between 2004 and 2020 using the National Cancer Database (NCDB). The analysis aimed to characterize regional differences in patient composition and stage at diagnosis to inform targeted public health strategies.
The analytic cohort comprised 986,555 patients. The mean age was 65.3 years and 60.1% of patients were male. The dataset as presented was predominately White (99.1%). Patients were assigned to one of six U.S. geographic regions based on the reporting facility, and descriptive comparisons were made across regions for demographic and socioeconomic variables as well as American Joint Committee on Cancer (AJCC) stage at diagnosis.
The investigators performed a cross-sectional analysis of diagnosed melanoma cases recorded in the NCDB from 2004 through 2020. Regional grouping was determined by the location of the reporting facility and analyses were descriptive in nature. Variables examined included age, sex, race and ethnicity, insurance type, household income category, urban–rural residence, and AJCC stage at diagnosis. The report focuses on observed variation across regions rather than on inferential modeling; methodological details beyond these descriptions were not reported in the abstract.
Across the full cohort, the mean age was 65.3 years and a majority were male (60.1%). The authors report that the cohort was overwhelmingly White (99.1%) as captured in the NCDB data. The study emphasizes that demographic composition varied by region, although specific region-by-region age or sex breakdowns beyond the overall means were not provided in the abstract.
Substantial regional socioeconomic variation was identified. Uninsured rates were highest in the Southwest (3.4%) and the Southeast (2.4%) relative to other U.S. regions. Household income in the lower category (reported as less than $63,000 in the abstract) predominated in the Southwest (75.9%) and the Southeast (67.9%). The authors interpret these findings as evidence of pronounced regional differences in socioeconomic factors that may influence access to care.
The proportion of patients presenting with advanced-stage disease (AJCC stage III–IV) differed across regions. Advanced-stage presentation was most common in the Southwest (13.0%) and least common in the Northeast (7.6%). Given melanoma’s prognosis being strongly linked to stage at diagnosis, the authors note that these regional differences in stage distribution may translate into meaningful differences in survival outcomes.
The study links observed geographic variation in stage at diagnosis and socioeconomic metrics to broader structural issues. The authors suggest that disparities likely reflect differences in access to screening and dermatologic services, variations in insurance coverage, and regional healthcare infrastructure. Because early-stage melanoma is frequently curable with surgery alone, higher rates of advanced-stage presentation in certain regions raise concern for avoidable morbidity and mortality tied to social determinants of health.
Based on the regional patterns identified, the authors recommend targeted, region-specific strategies to address observed inequities. Proposed approaches include Medicaid expansion, increased access to dermatologic care, public awareness campaigns focused on skin cancer detection, and targeted screening efforts in higher-risk regions. The abstract presents these recommendations as warranted measures to improve outcomes nationwide, given the stage-dependent prognosis for melanoma.
This analysis is descriptive and based on the NCDB; details regarding analytic adjustments, statistical testing, or region-specific covariate control are not reported in the abstract. The summary reflects results as presented in the source: counts, percentages, and regional comparisons reported by the authors. Any additional methodological or subgroup details beyond the abstract were not provided in the source material reviewed here.
Keywords from the study include melanoma, National Cancer Database, geographic disparities, socioeconomic factors, and stage at diagnosis. The findings underscore regional differences in socioeconomic context and stage distribution that may inform targeted public health interventions.