32316 Five-year cancer-specific survival for melanoma in LEP: An analysis of the SEER database

Abstract

Limited English Proficient (LEP) patients have been shown to have barriers to health care access. LEP is concentrated amongst Asian and Hispanic White populations. There is little known about cancer specific health outcomes for LEP melanoma patients. We hypothesized that there would be a statistically greater 5-year Cancer Specific Survival (CSS) in low LEP counties compared with high LEP counties. We performed a retrospective cross-sectional study on Asian and Hispanic White melanoma patients from the Surveillance, Epidemiology, and End Results database (SEER, 2018, 18 Reg.). 5-year CSS was compared between low LEP (0-12% LEP population) vs high LEP counties (≥12% LEP population) using a Kaplan-Meier analysis. A Cox proportional hazards regression was performed to investigate the effects of age of diagnosis, and county LEP status on 5-year CSS. A total of 8490 adult Asian and Hispanic White melanoma patients were identified, of whom 660 were in high LEP counties (7.8%). Mean age of diagnosis in high LEP counties (60.3 ± 17.7yo) was later than in low LEP counties (58.1 ± 16.9 yo, P = .002). 5-year melanoma CSS was marginally lower among patients in high LEP counties (P < .15). County LEP status did not confer a significant hazard (P = .334). 5-year melanoma CSS decreased with age of diagnosis (HR 1.01 per year, 95% CI [1.01-1.02]). Our results indicate that once diagnosed LEP does not affect a patient’s 5 year Cancer specific survival indicating the importance of melanoma screen in high LEP counties for early detection of melanoma. A limitation to this study is that it uses county level LEP data.