Mohammed Al Kurnas, Madison Webster, Xinxin Wu, Peter T Silberstein
{"title":"Impact of Demographics on Early-Stage vs. Stage IV Diagnosis in Amelanotic Melanoma: An Analysis of the National Cancer Database.","authors":"Mohammed Al Kurnas, Madison Webster, Xinxin Wu, Peter T Silberstein","doi":"10.7759/cureus.69398","DOIUrl":null,"url":null,"abstract":"<p><p>Introduction Amelanotic melanoma (AM) is a rare form of melanoma that lacks pigment. Although curable when diagnosed early, it is often missed or mistaken for other benign conditions. There has not been a study investigating the impact of demographic features on the diagnosis of stage 0-I (early-stage) versus stage IV AM. Objective This study addresses a gap in knowledge regarding demographic factors that influence the odds of early-stage vs. stage IV diagnosis of AM. Methods This study identified 684 patients from the National Cancer Database who were diagnosed with early-stage AM or stage IV AM from 2004 to 2020 and compared them based on age, sex, race, insurance, income, education, insurance status, rurality, facility type, geographic region, and Charleson-Deyo score. Socioeconomic and demographic features of patients with early-stage and stage IV were compared using the chi-squared test, the independent t-test, and multivariate logistic regression. Statistical significance was set at α = 0.05. Results Most cases analyzed were White (98.5%), male (57.7%), and lived in a metropolitan setting (86.7%). Males made up most of the early-stage and stage IV groups (55.0% vs. 45% and 66.5% vs. 33.5%, respectively, p < 0.05). Younger age is associated with decreased odds of stage IV disease (OR = 0.973, 95% CI = 0.952-0.993, p < 0.05). In addition, the female sex is associated with decreased odds of stage IV disease (OR = 0.584, 95% CI = 0.381-0.897, p < 0.05). Conclusions Age and sex are two variables that influence the odds of stage IV diagnosis in patients with AM, which is strongly associated with worse survival outcomes.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0000,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11402500/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cureus","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.7759/cureus.69398","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction Amelanotic melanoma (AM) is a rare form of melanoma that lacks pigment. Although curable when diagnosed early, it is often missed or mistaken for other benign conditions. There has not been a study investigating the impact of demographic features on the diagnosis of stage 0-I (early-stage) versus stage IV AM. Objective This study addresses a gap in knowledge regarding demographic factors that influence the odds of early-stage vs. stage IV diagnosis of AM. Methods This study identified 684 patients from the National Cancer Database who were diagnosed with early-stage AM or stage IV AM from 2004 to 2020 and compared them based on age, sex, race, insurance, income, education, insurance status, rurality, facility type, geographic region, and Charleson-Deyo score. Socioeconomic and demographic features of patients with early-stage and stage IV were compared using the chi-squared test, the independent t-test, and multivariate logistic regression. Statistical significance was set at α = 0.05. Results Most cases analyzed were White (98.5%), male (57.7%), and lived in a metropolitan setting (86.7%). Males made up most of the early-stage and stage IV groups (55.0% vs. 45% and 66.5% vs. 33.5%, respectively, p < 0.05). Younger age is associated with decreased odds of stage IV disease (OR = 0.973, 95% CI = 0.952-0.993, p < 0.05). In addition, the female sex is associated with decreased odds of stage IV disease (OR = 0.584, 95% CI = 0.381-0.897, p < 0.05). Conclusions Age and sex are two variables that influence the odds of stage IV diagnosis in patients with AM, which is strongly associated with worse survival outcomes.
导言黑色素瘤(AM)是一种缺乏色素的罕见黑色素瘤。虽然早期诊断可治愈,但它经常被漏诊或误诊为其他良性疾病。目前还没有一项研究调查了人口统计学特征对 0-I 期(早期)与 IV 期 AM 诊断的影响。目的 本研究填补了有关影响 AM 早期与 IV 期诊断几率的人口统计学因素的知识空白。方法 本研究从美国国家癌症数据库(National Cancer Database)中确定了 684 名在 2004 年至 2020 年期间被诊断为早期 AM 或 IV 期 AM 的患者,并根据年龄、性别、种族、保险、收入、教育程度、保险状况、农村地区、医疗机构类型、地理区域和 Charleson-Deyo 评分对他们进行了比较。采用卡方检验、独立 t 检验和多变量逻辑回归对早期和 IV 期患者的社会经济和人口特征进行了比较。统计显著性设定为 α = 0.05。结果 分析的大多数病例为白人(98.5%)、男性(57.7%)、居住在大都市(86.7%)。男性在早期和 IV 期病例中占多数(分别为 55.0% 对 45% 和 66.5% 对 33.5%,P < 0.05)。年龄越小,罹患 IV 期疾病的几率越小(OR = 0.973,95% CI = 0.952-0.993,P < 0.05)。此外,女性患 IV 期疾病的几率降低(OR = 0.584,95% CI = 0.381-0.897,p < 0.05)。结论 年龄和性别是影响 AM 患者确诊 IV 期几率的两个变量,而 IV 期与较差的生存预后密切相关。