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July 21, 2021

Melanoma and Racial Health Disparities in Black Individuals—Facts, Fallacies, and Fixes

Author Affiliations
  • 1Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
  • 2Dermatology Division, Department of Internal Medicine, Dell Medical School, The University of Texas at Austin
JAMA Dermatol. Published online July 21, 2021. doi:10.1001/jamadermatol.2021.2215

Black individuals have the shortest survival of any racial and ethnic group in the US for most cancers, including cutaneous melanoma.1 Complex factors, such as socioeconomic differences, lower health care access, structural racism, and higher rates of medical comorbidities, likely contribute to these inequalities. The observed differences in melanoma survival rates across racial groups have led to calls for intensifying primary (ie, ultraviolet radiation [UVR] protection) and secondary (ie, physician screening and/or self-examinations) prevention strategies for Black individuals.2,3 However, before doing so, it is crucial to carefully consider the risk factors, incidence, mortality, and survival rates of targeted populations, as well as the potential benefits and harms of any proposed interventions.

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    1 Comment for this article
    Melanoma Susceptibility Genes in African Americans
    Binh Ngo, M.D. | Keck USC School of Medicine
    The clinical diagnosis of melanoma in skin of color patients is challenging, undoubtedly contributing to delay of early treatment. The authors have rightly called attention to the need to do more to diagnose and treat melanoma in skin of color patients. Little is known of the genetic melanoma susceptibility patterns in patients with skin of color. The best characterized melanoma mutation CDKN2A has been described in relation to familial pancreatic carcinoma, but not melanoma in African Americans (1). Given the decreased survival of African American melanoma patients, it may be informative to genetically test African American melanoma patients for susceptibility genes to determine the incidence of familial melanoma.

    1) Doyle A, Kubler MM, Harris AC, et al . The impact of CDKN2A mutations on overall survival in pancreatic adenocarcinoma.Journal of Clinical Oncology 2019 37:4_suppl, 278-278