Patients with multiple comorbidities in addition to melanoma may be less likely to receive appropriate treatment than patients without comorbidities. Clinicians and health systems are encouraged to address these inequalities in melanoma treatment.
Disparities in the treatment of patients with melanoma exist in the United States and can have a negative impact on patient outcomes. Curative treatments are available to help improve the prognosis of melanoma in many patients. However, some patients may not be good candidates for curative melanoma treatment, according to an article in Anticancer Research, which could lead to worse disease severity. The objective of the authors was to investigate whether patient demographics have an impact on treatment contraindication in melanoma.
Data was gathered from the National Cancer Database (NCDB) to find patients with melanoma from 2004 to 2015. Researchers used multivariate logistic regression to evaluate independent associations, adjusted for confounders. Patients that did not receive treatment or those with unknown treatment status were excluded.
Out of 499,092 patients, 525 (0.1%) had treatment contraindicated for comorbid conditions (TCBC) and 498,567 (99.9%) of patients received treatment. Patients with government insurance or without insurance were more likely to experience TCBC than patients who had private insurance.
Disparities in demographics and comorbid conditions can have an impact on treatment decisions in patients with melanoma. Comorbidities may affect all levels of melanoma management, including prognosis, treatment, and survival. The extent of TCBC may be more apparent in older patients who may have more comorbidities and decreased immune system function. Clinicians are encouraged to assess the treatment goals of patients who have multiple comorbidities to improve survival or quality of life with melanoma. In addition, healthcare systems are advised to seek ways to address inequalities in melanoma treatment decisions in the United States.
Boczar, D., Bagaria, S. P., Spaulding, A. C., Huayllani, M. T., Avila, F. R., Guliyeva, G., Lu, X., Rinker, B. D., & Forte, A. J. (2021). Treatment Contraindications Based on Comorbidity Status in Patients With Melanoma in the United States. Anticancer Res, 41(4), 2067-2070. https://doi.org/10.21873/anticanres.14976