Social vulnerabilities in head-neck melanoma care: A retrospective cohort study in the United States.

Autor:	McCampbell L; Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee., Fei-Zhang DJ; Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois., Chelius D; Department of Otolaryngology-Head and Neck Surgery, Pediatric Thyroid Tumor Program and Pediatric Head and Neck Tumor Program, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas., Bob Hsia LL; Department of Dermatology, Medical University of South Carolina, Charleston, South Carolina., Dellavalle R; Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado., D'Souza J; Division of Pediatric Otolaryngology, Children's Hospital of New Orleans and Louisiana State University, New Orleans, Los Angeles., Bentrem D; Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois., Wayne J; Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois., Rastatter J; Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.; Division of Pediatric Otolaryngology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois., Sheyn A; Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee.; Department of Pediatric Otolaryngology, Le Bonheur Children's Hospital, Memphis, Tennessee.; Department of Pediatric Otolaryngology, St. Jude Children's Research Hospital, Memphis, Tennessee.
Jazyk:	angličtina
Zdroj:	JAAD international [JAAD Int] 2024 Jul 30; Vol. 17, pp. 37-47. Date of Electronic Publication: 2024 Jul 30 (Print Publication: 2024).
DOI:	10.1016/j.jdin.2024.05.011
Abstrakt:	Background: Studies addressing social determinants of health (SDH) in head-neck melanomas (HNM) have only assessed socioeconomic factor impact but not a wider scope of SDH. Objective: Utilizing the Social Vulnerability Index (SVI), to assess the influence of specific SDH and their quantifiable associations with HNM management disparities across the varied community contexts in the United States. Methods: This retrospective cohort study analyzed adults diagnosed with HNM from 1975 to 2017 from the Surveillance, Epidemiology, and End Results Program database. Results: A total of 374,138 HNM in adults from 1975 to 2017 were assessed for disparities affiliated with increasing overall vulnerability/SVI scores and SDH themes. For several melanoma subtypes, higher social vulnerability significantly decreased odds (lowest for amelanotic, odds ratio 0.74; 95% confidence interval, 0.63-0.86) for indicated surgery, increased odds of indicated radiation (highest for epithelioid cell, 1.44; 1.08-1.96), and advanced staging on first presentation (highest for acral lentiginous, 1.13; 1.01-1.27). Household composition, followed by socioeconomic status and minority-language status contributed significantly to the overall trend. Limitations: Limitations include unknown cause of death and SVI score calculation based on county of residency. Conclusions: This investigation highlights significant detrimental trends in HNM management with overall social vulnerability while showcasing the quantifiable associations of specific SDH themes on HNM-disparities. Competing Interests: Dr Chelius reported receiving a coordinator stipend from the American Academy of Otolaryngology outside the submitted work. No other disclosures are reported. Authors McCampbell and Fei-Zhang and Drs Hsia, Dellavalle, D’Souza, Bentrem, Wayne, Rastatter, and Sheyn have no conflicts of interest to declare. (© 2024 by the American Academy of Dermatology, Inc. Published by Elsevier Inc.)
Databáze:	MEDLINE
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