Biopsy Type Disparities in Patients With Melanoma: Who Receives the Standard of Care?

Abstract

To analyze whether demographic and facility type characteristics cause inequality in the type of biopsy performed in patients with cutaneous melanoma. The skin cancer National Cancer Database was assessed. Men and women of all ages with cutaneous melanoma in situ and malignant melanoma at any stage of the disease were included. Patients were selected who underwent one of the following biopsy types: excisional, punch, shave, or incisional. Bivariate and multivariate analyses were performed. We found that the likelihood of undergoing an excisional biopsy decreased in patients who were: Hispanic [odds ratio (OR)=0.63, confidence interval (CI)=0.55-0.71], non-White (OR=0.66, CI=0.58-0.76), older than 80 years (OR=0.77, CI=0.72-0.87), or in Comprehensive Community Cancer Programs (OR=0.33, CI=0.31-0.36), Community Cancer Programs (OR=0.52, CI=0.50-0.54) and Integrated Network Cancer Programs (OR=0.58, CI=0.55-0.61). Our study results demonstrate disparities in biopsy type in the treatment of melanoma.