---
title: "Regional Socioeconomic Disparities and Advanced-Stage Presentation in Melanoma (NCDB 2004–2020)"
id: "pubmed-42674720"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42674720"
content_type: "clinical_feed_article"
specialty: "Oncology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42674720/"
doi: "10.21873/anticanres.18348"
published_at: "2026-09-01T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Regional Socioeconomic Disparities and Advanced-Stage Presentation in Melanoma (NCDB 2004–2020)
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42674720
- **Specialty:** [Oncology](https://medichelpline.com/clinical-feed/oncology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42674720/)
- **DOI:** [10.21873/anticanres.18348](https://doi.org/10.21873%2Fanticanres.18348)
- **Published At:** 2026-09-01T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This cross-sectional analysis used the **National Cancer Database (NCDB)** to evaluate geographic variation in demographic, socioeconomic, and clinical characteristics of U.S. patients with **melanoma** diagnosed from 2004 to 2020. - The cohort included 986,555 patients with a mean age of 65.3 years; 60.1% were male. - Patients were assigned to one of six U.S. geographic regions according to the reporting facility; descriptive analyses examined age, sex, race/ethnicity, insurance type, income, urban-rural residence, and AJCC stage at diagnosis. - Substantial regional socioeconomic differences were identified. Uninsured rates were highest in the Southwest (3.4%) and Southeast (2.4%). - Lower household income (< $63,000) was most common in the Southwest (75.9%) and Southeast (67.9%). - Advanced-stage (AJCC stage III–IV) presentation varied by region: most common in the Southwest (13.0%) and least common in the Northeast (7.6%). - The cohort was overwhelmingly White (99.1%), as reported in the dataset. - Authors conclude that regional disparities in **socioeconomic factors** may correlate with differences in stage at diagnosis and potentially survival, likely reflecting structural inequities in screening access, insurance, and healthcare infrastructure. - Recommended region-specific strategies include Medicaid expansion, improving access to dermatologic care, public awareness campaigns, and targeted screening to reduce disparities in outcomes.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 University of Virginia, Charlottesville, VA, U.S.A.; lolafb@virginia.edu. * 2 Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S.A. * 3 Department of Surgery, Mayo Clinic Florida, Jacksonville, FL, U.S.A. * 4 Florida State University College of Medicine, Tallahassee, FL, U.S.A. * 5 Division of Surgical Oncology and Endocrine Surgery, UT Health, San Antonio, TX, U.S.A. * 6 Government Medical College and Hospital (GMCH), Chandigarh, India. * 7 University of Puerto Rico School of Medicine, San Juan, PR, U.S.A. * 8 Department of General Surgery, Division of Surgical Oncology, Mayo Clinic, Jacksonville, FL, U.S.A. * PMID: **42674720** * DOI: [ 10.21873/anticanres.18348 ](https://doi.org/10.21873/anticanres.18348) Item in Clipboard # Regional Disparities in Socioeconomic Factors and Advanced-stage Presentation in Melanoma: A National Cancer Database Analysis (2004-2020) Lola Fuentes Brock et al. Anticancer Res. 2026 Sep. Show details Display options Display options Format Abstract PubMed PMID Anticancer Res Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Anticancer+Res%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Anticancer+Res%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674720/) . 2026 Sep;46(9):4985-4991. doi: 10.21873/anticanres.18348. ### Authors [Lola Fuentes Brock](https://pubmed.ncbi.nlm.nih.gov/?term=Brock+LF&cauthor_id=42674720)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674720/#short-view-affiliation-1 "University of Virginia, Charlottesville, VA, U.S.A.; lolafb@virginia.edu."), [Berkay Demirors](https://pubmed.ncbi.nlm.nih.gov/?term=Demirors+B&cauthor_id=42674720)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674720/#short-view-affiliation-2 "Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S.A."), [Nikhil Godbole](https://pubmed.ncbi.nlm.nih.gov/?term=Godbole+N&cauthor_id=42674720)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674720/#short-view-affiliation-3 "Department of Surgery, Mayo Clinic Florida, Jacksonville, FL, U.S.A."), [Jade C Bowers](https://pubmed.ncbi.nlm.nih.gov/?term=Bowers+JC&cauthor_id=42674720)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42674720/#short-view-affiliation-4 "Florida State University College of Medicine, Tallahassee, FL, U.S.A."), [Harsheen K Manaise](https://pubmed.ncbi.nlm.nih.gov/?term=Manaise+HK&cauthor_id=42674720)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42674720/#short-view-affiliation-5 "Division of Surgical Oncology and Endocrine Surgery, UT Health, San Antonio, TX, U.S.A."), [Vishal Abhimutt Mahesh](https://pubmed.ncbi.nlm.nih.gov/?term=Mahesh+VA&cauthor_id=42674720)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42674720/#short-view-affiliation-6 "Government Medical College and Hospital \(GMCH\), Chandigarh, India."), [Anjali Yadav](https://pubmed.ncbi.nlm.nih.gov/?term=Yadav+A&cauthor_id=42674720)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42674720/#short-view-affiliation-6 "Government Medical College and Hospital \(GMCH\), Chandigarh, India."), [Paola Berrios Jimenez](https://pubmed.ncbi.nlm.nih.gov/?term=Jimenez+PB&cauthor_id=42674720)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42674720/#short-view-affiliation-7 "University of Puerto Rico School of Medicine, San Juan, PR, U.S.A."), [Benjamin Veenstra](https://pubmed.ncbi.nlm.nih.gov/?term=Veenstra+B&cauthor_id=42674720)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42674720/#short-view-affiliation-8 "Department of General Surgery, Division of Surgical Oncology, Mayo Clinic, Jacksonville, FL, U.S.A."), [Emmanuel Gabriel](https://pubmed.ncbi.nlm.nih.gov/?term=Gabriel+E&cauthor_id=42674720)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42674720/#short-view-affiliation-8 "Department of General Surgery, Division of Surgical Oncology, Mayo Clinic, Jacksonville, FL, U.S.A.") ### Affiliations * 1 University of Virginia, Charlottesville, VA, U.S.A.; lolafb@virginia.edu. * 2 Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S.A. * 3 Department of Surgery, Mayo Clinic Florida, Jacksonville, FL, U.S.A. * 4 Florida State University College of Medicine, Tallahassee, FL, U.S.A. * 5 Division of Surgical Oncology and Endocrine Surgery, UT Health, San Antonio, TX, U.S.A. * 6 Government Medical College and Hospital (GMCH), Chandigarh, India. * 7 University of Puerto Rico School of Medicine, San Juan, PR, U.S.A. * 8 Department of General Surgery, Division of Surgical Oncology, Mayo Clinic, Jacksonville, FL, U.S.A. * PMID: **42674720** * DOI: [ 10.21873/anticanres.18348 ](https://doi.org/10.21873/anticanres.18348) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background/aim:** Although melanoma represents only approximately 1% of skin cancers, it causes the majority of skin-cancer deaths. In its early stages, melanoma can be treated successfully with surgery alone, yet a meaningful proportion of patients still present with advanced disease. Geographic variation in demographic and socioeconomic profiles of patients with melanoma across U.S. regions remains poorly characterized. Assessment of regional disparities in patient composition and stage at diagnosis is necessary for the advancement of targeted public health strategies. This study examined geographic variation in demographic, socioeconomic, and clinical characteristics among U.S. patients with melanoma. **Patients and methods:** We conducted a cross-sectional analysis of patients diagnosed with melanoma between 2004 and 2020 using the National Cancer Database (NCDB). Patients were assigned to one of six U.S. geographic regions based on reporting facility location. Descriptive analyses were performed to evaluate age, sex, race and ethnicity, insurance type, income, urban-rural residence, and American Joint Committee on Cancer (AJCC) stage at diagnosis. **Results:** Among 986,555 patients (mean age, 65.3 years; 60.1% male), substantial socioeconomic variation was identified across regions. Uninsured rates were highest in the Southwest (3.4%) and Southeast (2.4%). Lower-income households (<$63,000) predominated in the Southwest (75.9%) and Southeast (67.9%). Advanced-stage (III-IV) disease at diagnosis was most common in the Southwest (13.0%) and least common in the Northeast (7.6%). The cohort was predominately White (99.1%). **Conclusion:** Substantial geographic variation exists in the demographic and socioeconomic profile of patients with melanoma, which may correlate to meaningful differences in stage at diagnosis and, given melanoma's strongly stage-dependent prognosis, potentially survival outcomes as well. These disparities likely reflect structural inequities in screening access, insurance coverage, and healthcare infrastructure. Region-specific interventions, including Medicaid expansion, increased access to dermatologic care, public awareness campaigns, and targeted screening, are warranted to improve outcomes nationwide. **Keywords:** Melanoma; National Cancer Database; geographic disparities; skin cancer; socioeconomic factors; stage at diagnosis. Copyright © 2026 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved. 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