Purpose

Previous studies have shown that individuals living in areas with persistent poverty (PP) experience worse cancer outcomes compared to those living in areas with transient or no persistent poverty (nPP). The association between PP and melanoma outcomes remains unexplored. We hypothesized that melanoma patients living in PP counties (defined as counties with ≥ 20% of residents living at or below the federal poverty level for the past two decennial censuses) would exhibit higher rates of incidence-based melanoma mortality (IMM).

Methods

We used Texas Cancer Registry data to identify the patients diagnosed with invasive melanoma or melanoma in situ (stages 0 through 4) between 2000 and 2018 (n = 82,458). Each patient’s PP status was determined by their county of residence at the time of diagnosis.

Results

After adjusting for demographic variables, logistic regression analyses revealed that melanoma patients in PP counties had statistically significant higher IMM compared to those in nPP counties (17.4% versus 11.3%) with an adjusted odds ratio of 1.35 (95% CI 1.25–1.47).

Conclusion

These findings highlight the relationship between persistent poverty and incidence-based melanoma mortality rates, revealing that melanoma patients residing in counties with persistent poverty have higher melanoma-specific mortality compared to those residing in counties with transient or no poverty. This study further emphasizes the importance of considering area-specific socioeconomic characteristics when implementing place-based interventions to facilitate early melanoma diagnosis and improve melanoma treatment outcomes.

中文翻译：

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德克萨斯州的持续贫困和基于发病率的黑色素瘤死亡率

目的

先前的研究表明，与生活在短暂或非持续贫困 (nPP) 地区的人相比，生活在持续贫困 (PP) 地区的个人的癌症结局更差。PP 与黑色素瘤结果之间的关联尚未被探索。我们假设生活在 PP 县（定义为过去两次十年一次的人口普查中 ≥ 20% 居民生活在联邦贫困线以下的县）的黑色素瘤患者将表现出较高的基于发病率的黑色素瘤死亡率 (IMM)。

方法

我们使用德克萨斯州癌症登记数据来确定 2000 年至 2018 年间诊断患有侵袭性黑色素瘤或原位黑色素瘤（0 至 4 期）的患者 ( n  = 82,458)。每个患者的 PP 状态由诊断时其居住县确定。

结果

调整人口变量后，逻辑回归分析显示，与 nPP 县的黑色素瘤患者相比，PP 县的黑色素瘤患者具有统计学显着更高的 IMM（17.4% 对 11.3%），调整后的比值比为 1.35（95% CI 1.25-1.47）。

结论

这些发现强调了持续贫困与基于发病率的黑色素瘤死亡率之间的关系，表明居住在持续贫困县的黑色素瘤患者与居住在短暂贫困或无贫困县的黑色素瘤患者相比，其黑色素瘤特异性死亡率更高。这项研究进一步强调了在实施基于地点的干预措施以促进早期黑色素瘤诊断和改善黑色素瘤治疗结果时考虑特定地区社会经济特征的重要性。