Racial and ethnic disparities in melanoma awareness: A cross-sectional survey.

BACKGROUND: Hispanics are among the fastest growing population in the United States and are predicted to account for one third of the nation by 2060. Although melanoma is more common among white patients, Hispanic individuals are at greater risk of late-stage diagnosis, increased tumor thickness, and poorer survival. OBJECTIVE: To better understand public awareness of melanoma and evaluate change over the last 21 years, particularly among high-risk minority populations. METHODS: A cross-sectional survey collecting information on knowledge and awareness of melanoma was conducted on 285 participants from May through November 2017. RESULTS: Approximately 39% of participants were unaware of melanoma. Sixty-five percent successfully identified early signs of disease. Approximately 86% of Fitzpatrick skin types (FST) I and II identified melanoma as a cancer, compared to 46.3% of FST III and IV and 57.6% of FST V and VI. Hispanic particiapnts were less likely to know what melanoma was compared to white participants (odds ratio [OR], 0.27; 95% confidence interval [CI], 0.65-0.11; P = .0037). US natives (OR, 2.38; 95% CI, 5.56-1.04; P = .0403) and patients with any college education (OR, 2.86; 95% CI, 5.26-1.54; P = .0007) were more likely to know the meaning of melanoma. CONCLUSION: White participants and those with any college education were more likely to know the meaning of melanoma. Individuals of racial and ethnic minorities would benefit from educational programs geared toward early detection.

Patient-provider comparison of dermatology vocabulary understanding: a cross-sectional study in patients from minority ethnic groups.

Patient-centered communication is necessary for a successful clinical relationship. There has been great interest in improving communication within the field of dermatology. To identify gaps between patient comprehension of dermatology-specific vocabulary and perceived comprehension by providers. Two hundred and eighty-five patients were recruited from outpatient dermatology clinics at Boston Medical Center and East Boston Neighborhood Health Center to complete a multiple choice survey regarding comprehension of dermatology-specific vocabulary. Participating patients were 59.6% female, with ages ranging from 18 to 94 years old, and a mean age of 45. Forty-six percent of patients identified as Hispanic/Latino, 36% as White. Fifty-five percent had a high school education or lower. Forty percent had an income of < 34,999/year. Seventy providers completed a questionnaire about their perception of patient understanding of dermatology-specific vocabulary. Patient and provider data were compared. About 60% of patients did not know the meaning of metastasis or hyperpigmentation, and approximately 55% did not understand excision or autoimmune. Providers overestimated patient comprehension of benign by 38% and sunburn and symptom by approximately 32%. Provider estimation exceeded actual patient comprehension of scar and recur by 27%. Sixty-six percent of providers cited "lack of time" as the largest communication barrier, while only 7% of patients believed additional time would improve communication. Limitations include sample size and generalizability. More than half of the patients surveyed did not understand metastasis, excision, hyperpigmentation, and autoimmune. Providers overestimated patient comprehension of benign, sunburn, symptom, scar, and recur.

Emerging Biomarkers in Cutaneous Melanoma.

Earlier identification of aggressive melanoma remains a goal in the field of melanoma research. With new targeted and immune therapies that have revolutionized the care of patients with melanoma, the ability to predict progression and monitor or predict response to therapy has become the new focus of research into biomarkers in melanoma. In this review, promising biomarkers are highlighted. These biomarkers have been used to diagnose melanoma as well as predict progression to advanced disease and response to therapy. The biomarkers take various forms, including protein expression at the level of tissue, genetic mutations of cancer cells, and detection of circulating DNA. First, a brief description is provided about the conventional tissue markers used to stage melanoma, including tumor depth. Next, protein biomarkers, which provide both diagnostic and prognostic information, are described. This is followed by a discussion of important genetic mutations, microRNA, and epigenetic modifications that can provide therapeutic and prognostic material. Finally, emerging serologic biomarkers are reviewed, including circulating melanoma cells and exosomes. Overall the goal is to identify biomarkers that aid in the earlier identification and improved treatment of aggressive melanoma.