A 'melanoma mortality belt' of ten U.S. states with the highest melanoma mortality rates.

Abstract

e21039 Background: To our knowledge, no study has looked at U.S. melanoma mortality trends by state. We sought to determine the ten states with the highest melanoma mortality rates (per white population) and those with the lowest, as well as any state-wide demographics that could account for these trends. Methods: State melanoma mortality rates were collected from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program and National Program for Cancer Registries. Data on state characteristics were collectied from the Area Health Resource File (AHRF) and the US Census Bureau. We used a regression model to determine associations between melanoma mortality and the state demographic context, such as median income, per capita income, unemployment rate, education level, and rural versus nonrural. We also examined the effect of access to health care resources by looking at density of dermatologists, density of primary care providers, and total number of hospitals. Results: We identified ten states concentrated across the central United States with the highest melanoma mortality rates. Per capita income was the only significant association for melanoma mortality rates (p = 0.0016, 95% CI 6.88 to 18.09). Median income, unemployment rate, education level, rural versus non-rural, health professional density, and unemployment rate were not associated with melanoma mortality rates by state. Conclusions: There exists a ‘melanoma mortality belt’ across the central United States made up of the ten states with the highest melanoma mortality rates. This trend could not be consistently accounted for by state demographics, even socioeconomic status traditionally thought to correlate with mortality. Only one significant association was seen between melanoma mortality rate and per capita income. Our preliminary findings highlight the multifactorial picture of geographic melanoma mortality inequalities in the U.S.