Mercè Grau-Pérez1, Camila Cabello2, Jesús-María González-Martín3, Leopoldo Borrego4, Gregorio Carretero2. 1. Universidad de Las Palmas de Gran Canaria, Calle Juan de Quesada 30, 35001 Las Palmas de Gran Canaria, Spain; Dermatology Department, Hospital Universitario de Gran Canaria Doctor Negrín, Barranco de la Ballena s/n, 35010 Las Palmas de Gran Canaria, Spain. Electronic address: merce.grau101@alu.ulpgc.es. 2. Dermatology Department, Hospital Universitario de Gran Canaria Doctor Negrín, Barranco de la Ballena s/n, 35010 Las Palmas de Gran Canaria, Spain. 3. Research Unit, Hospital Universitario de Gran Canaria Doctor Negrín, Barranco de la Ballena s/n, 35010 Las Palmas de Gran Canaria, Spain. 4. Universidad de Las Palmas de Gran Canaria, Calle Juan de Quesada 30, 35001 Las Palmas de Gran Canaria, Spain.
Abstract
BACKGROUND: An early diagnosis of cutaneous melanoma remains determinant for improved survival. Low educational attainment has been associated with a late-stage diagnosis in settings where access to healthcare is restricted. Little evidence is available from regions with universal healthcare. We aimed at analysing whether educational attainment was associated with Breslow thickness at diagnosis in a peripheral European region with universal healthcare (in the Canary Islands, Spain). METHODS: We conducted a cross-sectional study with prospectively collected data (2010-2017). Patients were recruited at diagnosis, and information about Breslow thickness, age at diagnosis, gender, highest educational attainment and site of melanoma were registered. Univariate and multivariate linear regression analyses were performed. RESULTS: Low educational attainment was associated with thicker tumours at diagnosis. The association remained true after adjustment for age, gender and site of melanoma. In the multivariate analysis, tumours diagnosed in patients with low educational attainment were on average 1.08 mm thicker (95% confidence interval: 0.36-1.81; p = 0.003) than those diagnosed in patients with high educational attainment. CONCLUSION: Public health strategies targeting this vulnerable group are currently needed in the Canary Islands (Spain).
BACKGROUND: An early diagnosis of cutaneous melanoma remains determinant for improved survival. Low educational attainment has been associated with a late-stage diagnosis in settings where access to healthcare is restricted. Little evidence is available from regions with universal healthcare. We aimed at analysing whether educational attainment was associated with Breslow thickness at diagnosis in a peripheral European region with universal healthcare (in the Canary Islands, Spain). METHODS: We conducted a cross-sectional study with prospectively collected data (2010-2017). Patients were recruited at diagnosis, and information about Breslow thickness, age at diagnosis, gender, highest educational attainment and site of melanoma were registered. Univariate and multivariate linear regression analyses were performed. RESULTS: Low educational attainment was associated with thicker tumours at diagnosis. The association remained true after adjustment for age, gender and site of melanoma. In the multivariate analysis, tumours diagnosed in patients with low educational attainment were on average 1.08 mm thicker (95% confidence interval: 0.36-1.81; p = 0.003) than those diagnosed in patients with high educational attainment. CONCLUSION: Public health strategies targeting this vulnerable group are currently needed in the Canary Islands (Spain).