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Persistent poverty and incidence-based melanoma mortality in Texas

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Abstract

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.

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Data availability

The data that support the findings of this study are available from the corresponding author on reasonable request.

Consent for publication

Not Applicable.

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Funding

Ms. Madrigal was supported by a generous gift from Walmart First Year Medical Students Summer Program directed to the PCCSM, Office of Faculty Diversity, Equity, and Inclusion. Ms. Morris was supported by the National Cancer Institute of the National Institutes of Health (R25CA056452). Dr. Tran was supported by a Research Grant from the Melanoma Research Foundation. Dr. Adamson was supported by Robert Wood Johnson Foundation, the Dermatology Foundation Public Health Career Development Award, the National Institutes of Health (UL1 TR002645), the American Cancer Society, and Meredith’s Mission for Melanoma. Dr. Adamson received Pilot Project Funding through the UT Austin/MD Anderson Cancer Center Pilot Project Grant. Dr. Bauer was supported in part by the Cancer Prevention Research Institute of Texas (RP20036). Dr. Nelson was supported in part by the Cancer Prevention Research Institute of Texas (RP20036) and received Pilot Project Funding through the UT Austin/MD Anderson Cancer Center Pilot Project Grant.

Role of the funder/sponsor

The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.

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Authors and Affiliations

  1. John P. and Kathrine G. McGovern Medical School, The University of Texas Health Science Center, Houston, TX, USA

    Karla Madrigal, Lillian Morris, Emelie Nelson & Madison M. Taylor

  2. Transitional Year Residency Program, HCA Houston Healthcare Kingwood, Kingwood, TX, USA

    Tiffaney Tran

  3. Impact Evaluation Core, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Marcita Galindez

  4. Division of Cancer Prevention and Population Sciences, Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Zhigang Duan

  5. Division of Dermatology, Dell Medical School, The University of Texas at Austin, Austin, TX, USA

    Adewole S. Adamson

  6. Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Hui Zhao, Hung Q. Doan, Madison M. Taylor & Kelly C. Nelson

  7. Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health Science Center, Houston, TX, USA

    Kehe Zhang & Cici Bauer

  8. Cancer Prevention & Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Marcita Galindez

  9. Center for Spatial-Temporal Modeling for Applications in Population Sciences, School of Public Health, The University of Texas Health Science Center, Houston, TX, USA

    Kehe Zhang & Cici Bauer

Authors
  1. Karla Madrigal
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  2. Lillian Morris
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  3. Kehe Zhang
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  4. Emelie Nelson
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  5. Tiffaney Tran
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  6. Marcita Galindez
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  7. Zhigang Duan
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  8. Adewole S. Adamson
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  9. Hui Zhao
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  10. Hung Q. Doan
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  11. Madison M. Taylor
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  12. Cici Bauer
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  13. Kelly C. Nelson
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Contributions

KCN and CB conceptualized the project. KZ, KCN, CB, HZ, and ASA contributed to the methods. KZ, MG, and ZD undertook all analyses. KZ and MG prepared figures. KCN, CB, MT, TT, EN, KM, and LM wrote the main manuscript text. All authors reviewed and approved the manuscript.

Corresponding authors

Correspondence to Cici Bauer or Kelly C. Nelson.

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The authors have no interests or relationships, financial or otherwise, which represent a potential conflict of interest.

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Madrigal, K., Morris, L., Zhang, K. et al. Persistent poverty and incidence-based melanoma mortality in Texas. Cancer Causes Control (2024). https://doi.org/10.1007/s10552-023-01841-5

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