The Role of Socioeconomic Status in Patients With Cutaneous Melanoma of the Head and Neck

Abstract

ObjectiveTo determine the effects of socioeconomic status (SES) on cutaneous melanoma of the head and neck.Data SourceSurveillance Epidemiology and End Results (SEER) Program.Review MethodsWe conducted a retrospective analysis of patients diagnosed with cutaneous melanoma of the head and neck from 2006 to 2018, utilizing population‐based data including socioeconomic status (SES) assessed by the US‐based Yost quintile index. SES quintiles ranged from Group 1 (lowest) to Group 5 (highest). We examined disease severity at diagnosis (stage, Breslow thickness, and spread) and survival outcomes (overall survival, cause‐specific survival) to assess the impact of SES.ResultsA total of 53,967 melanomas of the head and neck were identified (14,146 females; 39,821 males; 51,890 white; 125 black; 317 other). Group 1 patients had a significantly higher percentage of end‐stage disease (stage IV) at diagnosis (n = 101; 3.2% vs. n = 280; 1.9%, respectively) (p < .001), increased Breslow thickness (.80 mm vs .60 mm, respectively) (p < .001), and higher percentage of distant disease (n = 152; 3.6% vs. n = 431; 2.1%, respectively) (p < .001). Group 1 patients experienced a higher death rate from melanoma than group 5 patients (n = 585; 14% vs n = 1,753; 8.6%). Survival increased with SES.ConclusionsWhen evaluating cutaneous melanoma of the head and neck, low SES is related to more severe disease at diagnosis and worse survival outcomes. Addressing the underlying causes of this relationship could lead to more equitable management and survival outcomes.Level of EvidenceIII Laryngoscope, 2024