Although age-adjusted incidence rates (per 100,000) for melanoma are lower among Hispanics and blacks (4.5 and 1.0, respectively) compared with white non-Hispanics (21.6), melanomas among minority populations in the United States are more likely to metastasize and have poorer outcomes.
Methods
A review of the literature was conducted on melanomas affecting Hispanic and black Americans.
Results
Because of the low index of suspicion in both the medical community and these ethnic populations, diagnosis is often delayed, resulting in advanced presentation and a poorer prognosis.
Conclusions
More comprehensive medical training, expanded public educational campaigns, and increased awareness among patients of all skin types to perform self skin checks are recommended. Further studies elucidating the etiology and risk factors for melanoma among minority populations are warranted.
References
1.
RiesL.A.G., MelbertD., KrapchoM., eds. SEER Cancer Statistics Review, 1975-2004.National Cancer Institute, Bethesda, MD.http://seer.cancer.gov/csr/1975_2004/. Accessed March 7, 2008.
2.
JemalA., CleggL.X., WardE.. Annual report to the nation on the status of cancer, 1975-2001, with a special feature regarding survival.Cancer.2004; 101(1): 3–27.
3.
GreenleeR.T., MurrayT., BoldenS.. Cancer statistics, 2000.CA Cancer J Clin.2000; 50(1): 7–33.
4.
JemalA., SiegelR., WardE.. Cancer statistics, 2008.CA Cancer J Clin.2008;58(2): 71–96. Epub 2008 Feb 20.
5.
MarksR.. An overview of skin cancers: incidence and causation.Cancer.1995; 75(2 suppl): 607–612.
6.
SchafferJ.V., RigelD.S., KopfA.W.. Cutaneous melanoma: past, present, and future.J Am Acad Dermatol.2004; 51(1 suppl): S65–S69.
7.
CressR.D., HollyE.A.. Incidence of cutaneous melanoma among non-Hispanic whites, Hispanics, Asians, and blacks: an analysis of California cancer registry data, 1988-93.Cancer Causes Control.1997;8(2): 246–252.
8.
BellowsC.F., BelafskyP., FortgangI.S.. Melanoma in African-Americans: trends in biological behavior and clinical characteristics over two decades.J Surg Oncol.2001; 78(1): 10–16.
9.
CockburnM.G., ZadnickJ., DeapenD.. Developing epidemic of melanoma in the Hispanic population of California.Cancer.2006; 106(5): 1162–1168.
10.
O'HanlonL.. Invasive melanoma on the rise in California Hispanics.Lancet Oncol.2006; 7(3): 199.
11.
TsaiT., VuC., DE Henson. Cutaneous, ocular and visceral melanoma in African Americans and Caucasians.Melanoma Res.2005; 15(3): 213–217.
12.
IARC monographs on the evaluation of carcinogenic risks to humans: solar and ultraviolet radiation.IARC Monogr Eval Carcinog Risks Hum.1992; 55: 1–316.
13.
LeeJ.A., ScottoJ.. Melanoma: linked temporal and latitude changes in the United States.Cancer Causes Control.1993; 4(5): 413–418.
14.
LeeJ.A.. Latitude, coastal or interior location and the evaluation of the melanoma epidemic in the United States.Melanoma Res.1997; 7(3): 179–188.
15.
BulliardJ.L., CoxB., ElwoodJ.M.. Latitude gradients in melanoma incidence and mortality in the non-Maori population of New Zealand.Cancer Causes Control.1994; 5(3): 234–240.
16.
ArmstrongB.K., KrickerA.. The epidemiology of UV induced skin cancer.J Photochem Photobiol B.2001; 63(1-3): 8–18.
17.
MarksR.. Epidemiology of melanoma.Clin Exp Dermatol.2000; 25(6): 459–463.
18.
ByrdK.M., WilsonD.C., HoylerS.S.. Advanced presentation of melanoma in African Americans.J Am Acad Dermatol.2004; 50(1): 21–24; discussion 142-143.
19.
Byrd-MilesK., ToombsE.L., PeckG.L.. Skin cancer in individuals of African, Asian, Latin-American, and American-Indian descent: differences in incidence, clinical presentation, and survival compared to Caucasians.J Drugs Dermatol.2007; 6(1): 10–16.
20.
HalderR.M., AraC.J.. Skin cancer and photoaging in ethnic skin.Dermatol Clin.2003; 21(4): 725–732, x.
21.
ElderD.E.. Skin cancer. Melanoma and other specific nonmelanoma skin cancers.Cancer.1995; 75(1 suppl): 245–256.
22.
ArmstrongB., KrickerA.. How much melanoma is caused by sun exposure?Melanoma Res.1993; 3(6): 395–401.
23.
TadokoroT., KobayashiN., ZmudzkaB.Z.. UV-induced DNA damage and melanin content in human skin differing in racial/ethnic origin.FASEB J.2003; 17(9): 1177–1179. Epub 2003 Apr 8.
24.
YohnJ.J., LyonsM.B., NorrisD.A.. Cultured human melanocytes from black and white donors have different sunlight and ultraviolet A radiation sensitivities.J Invest Dermatol.1992; 99(4): 454–459.
25.
HuS., MaF., Collado-MesaF.. UV radiation, latitude, and melanoma in US Hispanics and blacks.Arch Dermatol.2004; 140(7): 819–824.
26.
KrishnamurthyS.. The geography of non-ocular malignant melanoma in India: its association with latitude, ozone levels and UV light exposure.Int J Cancer.1992; 51(2): 169–172.
27.
PennelloG., DevesaS., GailM.. Association of surface ultraviolet B radiation levels with melanoma and nonmelanoma skin cancer in United States blacks.Cancer Epidemiol Biomarkers Prev.2000; 9(3): 291–297.
28.
EideM.J., WeinstockM.A.. Association of UV index, latitude, and melanoma incidence in nonwhite populations: US Surveillance, Epidemiology, and End Results (SEER) Program, 1992-2001.Arch Dermatol.2005; 141(4): 477–481.
29.
BangK.M., HalderR.M., WhiteJ.E.. Skin cancer in black Americans: a review of 126 cases.J Natl Med Assoc.1987; 79(1): 51–58.
30.
CurtinJ.A., FridlyandJ., KageshitaT.. Distinct sets of genetic alterations in melanoma.N Engl J Med.2005; 353(20): 2135–2147.
31.
WhitemanD.C., WattP., PurdieD.M.. Melanocytic nevi, solar keratoses, and divergent pathways to cutaneous melanoma.J Natl Cancer Inst.2003; 95(11): 806–812.
32.
LachiewiczA.M., BerwickM., WigginsC.L.. Epidemiologic support for melanoma heterogeneity using the Surveillance, Epidemiology, and End Results Program.J Invest Dermatol. Epub 2007 Aug 23.
33.
BlackW.C., GoldhahnR.T.Jr, WigginsC.. Melanoma within a southwestern Hispanic population.Arch Dermatol.1987; 123(10): 1331–1334.
34.
PoeG.S., Powell-GrinerE., McLaughlinJ.K.. Comparability of the death certificate and the 1986 National Mortality Followback Survey.Vital Health Stat 2.1993(118): 1–53.
35.
HoweH.L., WuX., RiesL.A.. Annual Report to the nation on the status of cancer, 1975-2003, featuring cancer among U.S. Hispanic/Latino populations.Cancer.2006;107(8): 1711–1742.
36.
O'BrienK., CokkinidesV., JemalA.. Cancer statistics for Hispanics, 2003.CA Cancer J Clin.2003; 53(4): 208–226.
GallagherR.P., ElwoodJ.M., ThrelfallW.J.. Socioeconomic status, sunlight exposure, and risk of malignant melanoma: the Western Canada Melanoma Study.J Natl Cancer Inst.1987; 79: 647–652.
39.
LeeP.Y., SilvermanM.K., RigelD.S.. Level of education and the risk of malignant melanoma.J Am Acad Dermatol.1992; 26(1): 59–63.
40.
ReynoldsP., ElkinE.P., LayefskyM.E.. Cancer in California school employees, 1988-1992.Am J Ind Med.1999; 36(2): 271–278.
41.
ArmstrongB.K., EnglishD.R.. Cutaneous malignant melanoma. In: SchottenfeldD., FraumeniJFJr, eds. Cancer Epidemiology and Prevention.2nd ed.New York, NY: Oxford University Press Inc; 1996: 1282–1312.
42.
ElwoodJ.M.. Melanoma and sun exposure.Semin Oncol.1996; 23(6): 650–666.
43.
GhafoorA., JemalA., CokkinidesV.. Cancer statistics for African Americans.CA Cancer J Clin.2002; 52(6): 326–341.
44.
LoomisD., SchultzM.. Mortality from six work-related cancers among African Americans and Latinos.Am J Ind Med.2000; 38(5): 565–575.
45.
LoomisD., BrowningS.R., SchenckA.P.. Cancer mortality among electric utility workers exposed to polychlorinated biphenyls.Occup Environ Med.1997; 54(10): 720–728.
46.
SinksT., SteeleG., SmithA.B.. Mortality among workers exposed to polychlorinated biphenyls.Am J Epidemiol.1992; 136(4): 389–398.
47.
HutchesonA.C., McGowanJWIV, MaizeJ.C.Jr,. Multiple primary acral melanomas in African-Americans: a case series and review of the literature.Dermatol Surg.2007; 33(1): 1–10.
48.
StevensN.G., LiffJ.M., WeissN.S.. Plantar melanoma: is the incidence of melanoma of the sole of the foot really higher in blacks than whites?Int J Cancer.1990; 45(4): 691–693.
49.
HalderR.M., ShahS.B.. Skin cancer in African Americans.Cancer.1995; 75(2 suppl): 667–673.
50.
DowellJ.E., ShenY., HarfordW.V.. Case 1. Melanoma in African Americans.J Clin Oncol.2005; 23(15): 3622–3624.
51.
CormierJ.N., XingY., DingM., Lee. Ethnic differences among patients with cutaneous melanoma.Arch Intern Med.2006; 166(7): 1907–1914.
52.
BergfeltL., NewellG.R., SiderJ.G.. Incidence and anatomic distribution of cutaneous melanoma among United States Hispanics.J Surg Oncol.1989; 40(4): 222–226.
53.
HuS., ParkerD.F., ThomasA.G.. Advanced presentation of melanoma in African Americans: the Miami-Dade County experience.J Am Acad Dermatol.2004; 51(6): 1031–1032.
54.
CrowleyN.J., DodgeR., VollmerR.T.. Malignant melanoma in black Americans. A trend toward improved survival.Arch Surg.1991; 126(11): 1359–1364; discussion 1365.
55.
ReintgenD.S., McCartyK.M.Jr, CoxE.. Malignant melanoma in black American and white American populations: a comparative review.JAMA.1982; 248(15): 1856–1859.
56.
FeunL.G., RaubW.A.Jr, DuncanR.C.. Melanoma in a southeastern Hispanic population.Cancer Detect Prev.1994; 18(2): 145–152.
57.
RosenbergH.M., MaurerJ.D., SorlieP.D.. Quality of death rates by race and Hispanic origin: a summary of current research, 1999.Vital Health Stat 2.1999(128): 1–13.
58.
PipitoneM., RobinsonJ.K., CamaraC.. Skin cancer awareness in suburban employees: a Hispanic perspective.J Am Acad Dermatol.2002; 47(1): 118–123.
59.
HemmingsD.E., JohnsonD.S., TominagaG.T.. Cutaneous melanoma in a multiethnic population: is this a different disease?Arch Surg.2004; 139(9): 968–972; discussion 118-123.
60.
KirsnerR.S., WilkinsonJ.D., MaF.. The association of Medicare health care delivery systems with stage at diagnosis and survival for patients with melanoma.Arch Dermatol.2005; 141(6): 753–757.
61.
GlosterH.M.Jr, NealK.. Skin cancer in skin of color.J Am Acad Dermatol.2006; 55(5): 741–760; quiz 761-764.
62.
SaraiyaM., HallH.I., ThompsonT.. Skin cancer screening among U.S. adults from 1992, 1998, and 2000 National Health Interview Surveys.Prev Med.2004; 39(2): 308–314.
63.
SwanJ., BreenN., CoatesR.J.. Progress in cancer screening practices in the United States: results from the 2000 National Health Interview Survey.Cancer.2003; 97(6): 1528–1540.
64.
FreemanH.P.. Poverty, culture, and social injustice: determinants of cancer disparities.CA Cancer J Clin.2004; 54(2): 72–77.
65.
MargolisM.L., ChristieJ.D., SilvestriG.A.. Racial differences pertaining to a belief about lung cancer surgery: results of a multicenter survey.Ann Intern Med.2003; 139(7): 558–563.
66.
WardE., JemalA., CokkinidesV.. Cancer disparities by race/ethnicity and socioeconomic status.CA Cancer J Clin.2004; 54(2): 78–93.
67.
JemalA., MurrayT., WardE.. Cancer statistics, 2005.CA Cancer J Clin.2005; 55(1): 10–30. Erratum in: CA Cancer J Clin. 2005; 55(4): 259.
68.
StrykerJ.E., SolkyB.A., EmmonsK.M.. A content analysis of news coverage of skin cancer prevention and detection, 1979 to 2003.Arch Dermatol.2005; 141(4): 491–496.
69.
MaF., Collado-MesaF., HuS.. Skin cancer awareness and sun protection behaviors in white Hispanic and white non-Hispanic high school students in Miami, Florida.Arch Dermatol.2007: 143(8): 983–988.
70.
RamirezR.R., de la CruzG.P.. The Hispanic Population the United States: March 2002. Population Characteristics. Current Population Reports.Washington DC: US Department of Commerce, Economics and Statistics Administration, US Census Bureau; 2003.
71.
DennisL.K.. Analysis of the melanoma epidemic, both apparent and real: data from the 1973 through 1994 surveillance, epidemiology, and end results program registry.Arch Dermatol.1999; 135(3): 275–280.
