Patients with cutaneous melanoma who are of African descent have a general lower knowledge and poorer perception of their disease than patients who are White, and these factors contribute to more severe disease at presentation as well as worse prognosis in people of color, according data from a review of recent literature published in Dermatologic Therapy.
People of African descent generally have a lower incidence of cutaneous melanoma than people of European descent, primarily due to the higher concentration of protective melanin found in the former population. But people of African descent appear to be less aware of skin care risk, and as a result present at more severe stages of disease compared with patients who are White. Ultimately, this later stage of disease at presentation is predictive of worse outcomes and overall survival.
In a review of the literature, Anaba Ehiaghe, MD, of the Lagos State University Teaching Hospital in Nigeria, found that the incidence of cutaneous melanoma is increasing in all races. Research suggests that cutaneous melanoma, although commonly attributed to sun overexposure in White patients, has not been proven to be associated with ultraviolet radiation exposure in people of African descent. Little research has been conducted on the effects of blue light, but current evidence suggests this form of visible light mostly contributes to hyperpigmentation in skin of color, it was noted.
Additional research reports that cutaneous melanoma in acral sites in people of African descent is sometimes misdiagnosed as benign. Melanoma-specific survival has also been consistently reported as worse in people of African descent, irrespective of age, sex, anatomical site, and stage at diagnosis. Surgical intervention is more frequent in White patients compared with people of African descent, according to the review, but most of the same modalities are used across races/ethnicities.
The researcher of this review study suggests the differences in patients who are White vs patients who are of African descent “are influenced by socioeconomic indices with a consequent racial difference in attitude and behavior towards cutaneous melanoma.”
Anaba EL. Comparative study of cutaneous melanoma and its associated issues between people of African decent and Caucasians. Published online January 21, 2021. Dermatol Ther. doi:10.1111/dth.14790