Social vulnerabilities in head-neck melanoma care: A retrospective cohort study in the United States.

head and neck melanoma melanoma treatment social determinants of health

Journal

JAAD international
ISSN: 2666-3287
Titre abrégé: JAAD Int
Pays: United States
ID NLM: 101774762

Informations de publication

Date de publication:
Dec 2024
Historique:
accepted: 26 05 2024
medline: 15 10 2024
pubmed: 15 10 2024
entrez: 15 10 2024
Statut: epublish

Résumé

Studies addressing social determinants of health (SDH) in head-neck melanomas (HNM) have only assessed socioeconomic factor impact but not a wider scope of SDH. Utilizing the Social Vulnerability Index (SVI), to assess the influence of specific SDH and their quantifiable associations with HNM management disparities across the varied community contexts in the United States. This retrospective cohort study analyzed adults diagnosed with HNM from 1975 to 2017 from the Surveillance, Epidemiology, and End Results Program database. A total of 374,138 HNM in adults from 1975 to 2017 were assessed for disparities affiliated with increasing overall vulnerability/SVI scores and SDH themes. For several melanoma subtypes, higher social vulnerability significantly decreased odds (lowest for amelanotic, odds ratio 0.74; 95% confidence interval, 0.63-0.86) for indicated surgery, increased odds of indicated radiation (highest for epithelioid cell, 1.44; 1.08-1.96), and advanced staging on first presentation (highest for acral lentiginous, 1.13; 1.01-1.27). Household composition, followed by socioeconomic status and minority-language status contributed significantly to the overall trend. Limitations include unknown cause of death and SVI score calculation based on county of residency. This investigation highlights significant detrimental trends in HNM management with overall social vulnerability while showcasing the quantifiable associations of specific SDH themes on HNM-disparities.

Sections du résumé

Background UNASSIGNED
Studies addressing social determinants of health (SDH) in head-neck melanomas (HNM) have only assessed socioeconomic factor impact but not a wider scope of SDH.
Objective UNASSIGNED
Utilizing the Social Vulnerability Index (SVI), to assess the influence of specific SDH and their quantifiable associations with HNM management disparities across the varied community contexts in the United States.
Methods UNASSIGNED
This retrospective cohort study analyzed adults diagnosed with HNM from 1975 to 2017 from the Surveillance, Epidemiology, and End Results Program database.
Results UNASSIGNED
A total of 374,138 HNM in adults from 1975 to 2017 were assessed for disparities affiliated with increasing overall vulnerability/SVI scores and SDH themes. For several melanoma subtypes, higher social vulnerability significantly decreased odds (lowest for amelanotic, odds ratio 0.74; 95% confidence interval, 0.63-0.86) for indicated surgery, increased odds of indicated radiation (highest for epithelioid cell, 1.44; 1.08-1.96), and advanced staging on first presentation (highest for acral lentiginous, 1.13; 1.01-1.27). Household composition, followed by socioeconomic status and minority-language status contributed significantly to the overall trend.
Limitations UNASSIGNED
Limitations include unknown cause of death and SVI score calculation based on county of residency.
Conclusions UNASSIGNED
This investigation highlights significant detrimental trends in HNM management with overall social vulnerability while showcasing the quantifiable associations of specific SDH themes on HNM-disparities.

Identifiants

DOI: 10.1016/j.jdin.2024.05.011 PMID: 39403407 PMC: PMC11472106
pubmed: 39403407
doi: 10.1016/j.jdin.2024.05.011
pii: S2666-3287(24)00100-7
pmc: PMC11472106
doi:

Types de publication

Journal Article

Langues

eng

Pagination

37-47

Informations de copyright

© 2024 by the American Academy of Dermatology, Inc. Published by Elsevier Inc.

Déclaration de conflit d'intérêts

Dr Chelius reported receiving a coordinator stipend from the American Academy of Otolaryngology outside the submitted work. No other disclosures are reported. Authors McCampbell and Fei-Zhang and Drs Hsia, Dellavalle, D’Souza, Bentrem, Wayne, Rastatter, and Sheyn have no conflicts of interest to declare.

Auteurs

Lillian McCampbell (L)

Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee.

David Jun Fei-Zhang (DJ)

Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Daniel Chelius (D)

Department of Otolaryngology-Head and Neck Surgery, Pediatric Thyroid Tumor Program and Pediatric Head and Neck Tumor Program, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas.

Ling-Lun Bob Hsia (LL)

Department of Dermatology, Medical University of South Carolina, Charleston, South Carolina.

Robert Dellavalle (R)

Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado.

Jill D'Souza (J)

Division of Pediatric Otolaryngology, Children's Hospital of New Orleans and Louisiana State University, New Orleans, Los Angeles.

David Bentrem (D)

Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Jeffrey Wayne (J)

Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Jeffrey Rastatter (J)

Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Division of Pediatric Otolaryngology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.

Anthony Sheyn (A)

Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee.
Department of Pediatric Otolaryngology, Le Bonheur Children's Hospital, Memphis, Tennessee.
Department of Pediatric Otolaryngology, St. Jude Children's Research Hospital, Memphis, Tennessee.

Classifications MeSH