Marissa L H Baranowski1, Howa Yeung2, Suephy C Chen3, Theresa W Gillespie4, Michael Goodman5. 1. Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia; Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia. 2. Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia; Regional TeleHealth Service, Veterans Integrated Services Network 7, Decatur, Georgia. 3. Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia; Regional TeleHealth Service, Veterans Integrated Services Network 7, Decatur, Georgia; Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia. 4. Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia; Department of Surgery, Emory University School of Medicine, Atlanta, Georgia. 5. Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia. Electronic address: mgoodm2@emory.edu.
Abstract
BACKGROUND: Timely treatment for melanoma may affect survival, and characterizing the predictors of delay may inform intervention strategies. OBJECTIVE: To determine characteristics associated with the interval between diagnosis and surgery in melanoma. METHODS: The National Cancer Database was used to examine factors associated with the interval between diagnosis and surgery among 213 146 patients with stage I, II, or III cutaneous melanoma. RESULTS: Among privately insured patients, time to surgery was longer for patients aged 50 to 70 years (hazard ratio [HR], 0.96) and older than 70 years (HR, 0.83) compared with those younger than 50 years. In contrast, patients without private insurance experienced a shorter surgical wait time if older (HR for age 50-70 years, 1.07; HR for age >70 years, 1.05). Other factors associated with longer surgical interval included nonwhite race, less education, higher comorbidity burden, advanced stage, and head or neck melanoma location. LIMITATIONS: Use of zip code-level data for income and education level. CONCLUSION: Patients with melanoma experience disparities in timely receipt of surgery.
BACKGROUND: Timely treatment for melanoma may affect survival, and characterizing the predictors of delay may inform intervention strategies. OBJECTIVE: To determine characteristics associated with the interval between diagnosis and surgery in melanoma. METHODS: The National Cancer Database was used to examine factors associated with the interval between diagnosis and surgery among 213 146 patients with stage I, II, or III cutaneous melanoma. RESULTS: Among privately insured patients, time to surgery was longer for patients aged 50 to 70 years (hazard ratio [HR], 0.96) and older than 70 years (HR, 0.83) compared with those younger than 50 years. In contrast, patients without private insurance experienced a shorter surgical wait time if older (HR for age 50-70 years, 1.07; HR for age >70 years, 1.05). Other factors associated with longer surgical interval included nonwhite race, less education, higher comorbidity burden, advanced stage, and head or neck melanoma location. LIMITATIONS: Use of zip code-level data for income and education level. CONCLUSION:Patients with melanoma experience disparities in timely receipt of surgery.
Authors: Raghav Tripathi; Laura K Archibald; Rishabh S Mazmudar; Rosalynn R Z Conic; Luke D Rothermel; Jeffrey F Scott; Jeremy S Bordeaux Journal: J Am Acad Dermatol Date: 2020-04-08 Impact factor: 11.527