Study: Men with skin of color have lowest melanoma survival rates

Melanoma, the most serious form of skin cancer, is highly treatable when detected early, but when the disease advances, it can lead to death. A new article published in the Journal of the American Academy of Dermatology reveals that men – and particularly men with skin of color – are more likely to die from melanoma than women. 

“We know that men may be less likely to seek medical care than women, so they can be diagnosed with melanoma at later stages,” said board-certified dermatologist and co-author of the study Ashley Wysong, MD, founding chair of the UNMC Department of Dermatology. “However, even after accounting for later stages at diagnosis, men still have worse survival rates than women with melanoma, so we suspect that there are some tumor-specific factors and potentially biological factors at play, such as hormones and the way the body responds to melanoma tumors.”  

The analysis involved more than 200,000 participants and is the largest study to date on racial differences in men with melanoma. It compared melanoma diagnosis data from the National Cancer Database from 2004 until 2018 in white, Black, Asian, American Indian/Alaskan Native and Hispanic men. 

Melanoma survival rates were highest for white men (75%), followed by American Indian/Alaskan Native (69%), Asian (68%), Hispanic (66%) and Black men (52%). White and indigenous men were more likely to develop melanoma on the trunks of their bodies, while Black, Asian and Hispanic men were more likely to develop it in their lower extremities.  

“Patients with darker skin tones are more likely to get melanomas in areas that are not sun-exposed, whereas patients with lighter skin tones are more likely to have melanomas on areas of the skin exposed to the sun,” Dr. Wysong said.  

The study also showed that Black, Hispanic and Asian men are more likely to have melanoma diagnosed at an advanced stage when it is more difficult to treat. 

“The location of the melanoma can play a role in this issue,” Dr. Wysong said. “Many patients have spots evaluated by dermatologists because somebody else has pointed out a spot to them. Melanoma in areas that do not have sun exposure can be more difficult for both patients and their loved ones to see, which can lead to a delayed diagnosis.” 

Since melanoma often appears as a brown or dark spot on the body, it can be easier to see on lighter skin tones because there is a greater difference between the colors, she said. Melanoma in patients with darker skin tones often can be mistaken for other skin conditions, which can lead to a delay in diagnosis.   

Dr. Wysong said she encourages people to reduce their risk of skin cancer by seeking shade when appropriate, especially when the sun’s rays are the strongest, wearing sun-protective clothing and applying a broad-spectrum water-resistant sunscreen with an SPF of 30 or higher.

Researchers are uncertain exactly why men have worse survival rates than women, Dr. Wysong said, underscoring the need for more research in the area, including a better understanding of social determinants of health, which are the economic and social conditions that affect peoples’ health, in melanoma and the importance of men being screened by a board-certified dermatologist. 

“We hope our research can lay the foundation for future studies to determine why there’s such a gap in survival rates and to make headway to reduce these survival rate gaps,” Dr. Wysong said. “If someone notices that they have any lesions on their skin that are troubling, growing, bleeding or just not healing, then they should see a board-certified dermatologist.” 

To find a board-certified dermatologist in your area, visit the American Academy of Dermatology.