Abstract PR010: Cutaneous melanoma treatment outcomes in Texas: A study of the Texas Cancer Registry/Medicare linked database and an analysis of disparities
Authors: Riva Hannah R. , Ramirez Fabiola , Fernandez Lorena , Kye Yae , Lopez David , Digbeu Biai , Chacon Jessica 
Published: December 2023

Abstract
Background: Given that Hispanics make up a large portion of the United States, further research has been necessary to analyze the effects of treatment methods on all-cause and skin cancer mortality in Hispanic populations. While Caucasians have the highest incidence of melanoma, Hispanics make up the second most common group in the United States and in Texas. Incidence of melanoma is increasing, including in the Hispanic population. Importantly, mortality from melanoma is higher in the Hispanic than in the Caucasian population. Methods: We conducted an analysis of patients with cutaneous melanoma in the Texas Cancer Registry Medicare database to assess treatment modalities used and outcomes among demographic groups from 2007 to 2018. A bivariate analysis using Chi-square, Fisher’s exact test, and Student’s T-Test was done to compare patient, clinical, cancer and treatment characteristics between Hispanic and Non-Hispanic White (NHW). A Cox Proportional Hazard regression analysis was performed to assess treatment effect on outcome, with race-ethnicity as an effector modifier. Models were adjusted for patient age, sex, cancer stage, primary care provider, and comorbidity. Results: A higher percentage of Hispanic patients (7.6%) presented with a metastatic tumor stage diagnosis and cancer-related mortality (22.11%) compared to NHW patients (p &lt;0 .0001). In both the Hispanic and NHW cohorts, post-diagnosis radiation (Hispanic 95% CI 0.984 – 2.634, NHW 95% CI 2.082-2.648) and post-diagnosis chemotherapy (Hispanic 95% CI 1.085-3.321, NHW 95% CI 1.664-2.489) are each associated with an increased risk in cancer-related mortality. Similar results are seen with post-diagnosis radiation (Hispanic 95% CI 1.121-2.40, NHW 95% CI 1.644-1.971) and chemotherapy (Hispanic 95% CI 0.900-2.368, NHW 95% CI 1.356-1.869) when considering all-cause mortality in both populations. However, post-diagnosis surgery (95% CI 0.571-0.678) and post-diagnosis immunotherapy (95% CI 0.032-1.565) had the opposite effect in cancer-related mortality for NHW. Cancer-related mortality for post-diagnosis surgery in the Hispanic cohort had a similar trend (95% CI 0.395-0.856), yet the effect of post-diagnosis immunotherapy was dismissed due to small sample size. Conclusion: Our results propose differences in all-cause and cancer-only related mortality with separate treatment modalities, particularly with chemotherapy and radiation therapy; this retrospective cohort study validated that health disparities exist in the Hispanic Medicare population of Texas with cutaneous melanoma.
Citation Format: Hannah R. Riva, Fabiola Ramirez, Lorena Fernandez, Yae Kye, David Lopez, Biai Digbeu, Jessica Chacon. Cutaneous melanoma treatment outcomes in Texas: A study of the Texas Cancer Registry/Medicare linked database and an analysis of disparities [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr PR010.