ROCHESTER, Minn. — A study conducted by the Mayo Clinic has revealed that melanoma, an aggressive form of skin cancer responsible for 75% of all skin-cancer-related deaths, is often detected later in individuals with darker skin complexions. This delay can lead to devastating consequences.
Although melanoma is less frequently found in people with darker complexions compared to those with fairer ones, this potentially severe form of cancer can affect anyone. The study, which included 492,597 patients diagnosed with melanoma, indicates that early screening needs to be particularly vigilant for Black men. Their cancers are often discovered at later stages, resulting in worse outcomes compared to white patients.
"We compared non-Hispanic Black patients to white patients and saw striking differences in how patients presented with the disease," says surgical oncologist Tina Hieken, M.D., senior author of the study and a researcher at Mayo Clinic Comprehensive Cancer Center. "We saw more extremity melanoma and more later-stage disease."
Extremity melanoma refers to skin cancer that develops on the arms, legs, hands and feet. Various factors such as social risk factors and biological components could contribute to these differences; however, further research is needed.
The research found that Black female patients with melanoma fared better than their male counterparts. Men were generally older at diagnosis and more likely to have cancer spread to their lymph nodes compared to women. This resulted in lower survival rates: Black men with stage 3 melanoma have only a 42% chance of surviving for five years compared to 71% for Black women.
Most previous research on melanoma has not focused on how race and sex influence outcomes across all groups. Dr. Hieken emphasizes that this study underscores the need for a better understanding of these differences.
"When we talk about later-stage melanoma patients who are female versus male in that non-Hispanic Black patient cohort who ended up doing worse, some biological things may be going on here that are interesting," says Dr. Hieken.
One theory suggests variations in immune response. "Several immune signals suggest that women may respond better to some immunotherapies than males," says Dr. Hieken.
The researchers highlight the need for more studies focusing on melanoma in a broader range of people, including more Black participants in clinical trials. This could bridge the knowledge gap and potentially identify more effective treatments.
"We want to broaden and deepen our reach to better understand the disease that affects all patients," says Dr. Hieken.
Dr. Hieken emphasizes the importance of healthcare professionals carefully examining areas like palms, soles and under fingernails, where melanoma might be more challenging to spot on darker skin.
The Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery and Breast and Melanoma Surgical Oncology in the Department of Surgery supported this research.
