Despite presenting with similar disease severity at diagnosis, such as Breslow thickness and ulceration status, Black patients with acral lentiginous melanoma face higher mortality rates than Caucasian patients, an urgent disparity demanding clarity and action in clinical practice.
Acral melanoma, particularly the acral lentiginous subtype, represents a rare but aggressive form of skin cancer, and its epidemiology reveals profound inequities. A recent analysis has confirmed that Black individuals with acral lentiginous melanoma experience higher mortality despite comparable disease severity at diagnosis. This underrecognized challenge highlights a critical blind spot in both dermatology and oncology.
This survival gap cannot be explained by tumor characteristics alone. Instead, non-clinical determinants—encompassing healthcare access barriers, delayed referrals to specialist care and financial constraints—emerge as powerful drivers. Earlier findings suggest these socioeconomic factors in cancer operate alongside existing treatment protocols to widen mortality racial differences, undermining equity in melanoma outcomes.
Data from a SEER database study further illustrates how survival rates diverge sharply by race, reflecting entrenched health disparities. Patients from underprivileged communities often present later, receive less comprehensive follow-up and encounter systemic obstacles that compound clinical risk. Recognizing these patterns is essential for refining risk stratification and tailoring intervention strategies.
Addressing acral melanoma disparities will require clinicians to integrate social determinants into routine assessment, expedite pathways for at-risk populations, and collaborate with multidisciplinary teams to navigate non-medical challenges. Integrating equity metrics into clinical guidelines and fostering partnerships with community resources can transform awareness into actionable change.
Key Takeaways:- Disparities in melanoma mortality among racial groups persist despite similar disease severity at diagnosis.
- Non-clinical factors, such as socioeconomic status and healthcare access, significantly affect outcomes.
- Incorporating social determinants into clinical assessment and care pathways is vital to mitigate these inequities.