The Impact of Demographics, Socioeconomics, and Healthcare Access on Melanoma Outcomes.
Disparities in melanoma care exist in the United States. Disparities in provider type, patient demographics, place of residence, insurance status, socioeconomic status (SES), race/ethnicity and age impact melanoma outcomes. Melanomas detected by dermatologists are thinner, at an earlier stage and have better survival outcomes, compared with detection by primary care providers or patients. Lower SES, race/ethnicity and place of residence are associated with decreased access to and/or utilization of dermatologists, and more advanced melanomas at diagnosis. Additionally, uninsured and publicly-insured individuals are more likely to present with late-stage melanomas, resulting in worse outcomes. This review provides a comprehensive overview of how structural and patient-level characteristics influence melanoma outcomes in order to inform clinical care and healthcare policy as it relates to addressing gaps in melanoma care.