Melanoma Deadlier for Blacks, Hispanics

Melanoma may be more common in whites but the most serious form of skin cancer is deadlier in blacks and Hispanics because it is more likely to go undetected, researchers report.

Blacks are more than three times as likely as whites to be diagnosed with melanoma after it has reached a late stage, and Hispanics are nearly twice as likely, according to a University of Miami study released Monday.

Late diagnosis of melanoma generally significantly reduces the chances for survival. The survival rate for those with early detection is about 99 percent, according to the National Cancer Institute. With later detection, the survival rate falls to between 15 and 65 percent, depending on how far the disease has spread.

The American Cancer Society estimates that more than 10,000 people will die from skin cancer this year, nearly 80 percent of them from melanoma.

The study, published in the journal Archives of Dermatology, analyzed 1,690 melanoma cases in Miami-Dade County from 1997 through 2002.

One author of the study, Dr. Robert Kirsner, a University of Miami dermatologist, said researchers did not focus on possible causes for the disparity, but he noted that blacks and Hispanics tend to have less access to medical care.

Also, because the disease is more likely to occur in light-skinned people, many prevention and detection efforts are aimed at them, he said.

"Patients may be coming to (doctors) with some concerns, but because of the patient's ethnic or racial makeup, the doctor may put melanoma lower on the list of potential diagnoses and not evaluate it in the same way," Kirsner said.

The report reinforces the results of other nationwide cancer studies, said an outside observer, cancer epidemiologist Myles Cockburn of the University of Southern California.

While distinct types of melanoma may afflict different ethnicities, the main problem is the failure to spot signs of melanoma early, Cockburn said.

"It's a very frustrating disease because it's one of those diseases that nobody should ever die from," he said.

Of the cases studied, 70 percent involved white non-Hispanics, 29 percent were Hispanics and 2 percent were black non-Hispanics. U.S. Census figures for Miami-Dade show 19 percent of residents are white non-Hispanic, 60 percent are Hispanic and 20 percent are black non-Hispanic.

Skin cancer is the most common of all cancers, amounting to about half of all cases. It is about twice as common in men as in women and is becoming more common in children and young adults.