https://openworks.mdanderson.org/sumexp22/1123/thumbnail.jp

Adamson, Adewole

Bauer, Cici X

Doan, Hung Q.

Dorsey, Chloe N

Duan, Zhigang

Galindez, Marcita S

Madrigal, Karla

Morris, Lillian K

Nelson, Emelie E

Nelson, Kelly C

Simon, Julie M.

Zhao, Hui

English

OpenWorks @ MD Anderson

BackgroundPatients in United States counties with persistent poverty (PP, ≥20% of residents in poverty since 1980) experience significantly higher cancer associated mortality than individuals living in non-PP counties.1,2 While markers of lower socioeconomic status have been correlated to higher melanoma mortality, the relationship of persistent poverty and melanoma mortality has not been explored.This project aims to better understand how persistent poverty influences melanoma mortality in the state of Texas. Ultimately, we hope to develop outreach efforts for patients living in regions of persistent poverty and help primary care physicians diagnose melanoma at earlier, more treatable stages.ConclusionAge, race/ethnicity, sex, and poverty designation are associated with significant disparities in incidence-adjusted melanoma-specific mortality outcomes. Acknowledgements This study was supported by the philanthropic contributions of:● the Lyda Hill Foundation to The University of Texas MD Anderson Cancer Center Moon Shots Program● UT Austin/MD Anderson Cancer Center Collaborative Pilot Project Grants● Partnership for Careers in Cancer Science and Medicine● The Cancer Prevention Research Training Program, NIH/NCI R25CA056452 (Lillian Morris, Shine Chang, Ph.D., Principal Investigator) References1. Moss JL, Pinto CN, Srinivasan S, Cronin KA, Croyle RT. Enduring Cancer Disparities by Persistent Poverty, Rurality, and Race: 1990-1992 to 2014-2018. J Natl Cancer Inst. Jun 13 2022;114(6):829-836. doi:10.1093/jnci/djac0382. Moss JL, Pinto CN, Srinivasan S, Cronin KA, Croyle RT. Persistent Poverty and Cancer Mortality Rates: An Analysis of County-Level Poverty Designations. Cancer Epidemiol Biomarkers Prev. Oct 2020;29(10):1949-1954. doi:10.1158/1055-9965.EPI-20-0007The Association Between Persistent Poverty and Melanoma Mortality in Texas: A Retrospective Study Using Texas Cancer Registry DataKarla Madrigal1,3; Lillian K. Morris1,3; Emelie E. Nelson1,3; Adewole Adamson2; Zhigang Duan3; Hui Zhao3; Julie M. Simon3; Chloe N. Dorsey3; Marcita S. Galindez3; Hung Q. Doan3; Cici X. Bauer4; Kelly C. Nelson31McGovern Medical School, The University of Texas Health Science Center at Houston; 2Dell Medical School, The University of Texas at Austin; 3University of Texas MD Anderson Cancer Center; ; 4University of Texas Health Science Center at Houston School of Public Health Methods● Obtained data from 87,713 patients diagnosed with melanoma between 2000-2018 from the Texas Cancer Registry. ● Identified 56 PP counties in Texas with 2021 US Economic Development Administration data. ● Used mixed effect models to assess melanoma-specific mortality rates by persistent poverty, age, sex, and race/ethnicity. ResultsFuture Research● Explore melanoma mortality in PP counties before and after 2011 to better understand the impacts of immune-checkpoint inhibition treatments.● Create educational platforms that teach primary care physicians in PP counties how to better diagnose skin cancer. ● Identify persistent poverty as a place-based social determinant of health.DiscussionSignificant health disparities exist in many Texas counties, especially those that meet PP criteria. Many of these PP counties are located along the US-Mexico border and house a significant  immigrant population. The high poverty rates in these areas may be exacerbated by legal status, language barriers, higher unemployment rates, environmental factors, educational inequalities, and lack of access to medical care. More prevention practices and education need to be implemented in these areas to further decrease melanoma incidence-based mortality rates.  Table 1: Incidence-adjusted melanoma mortality compared to all-cause mortality in Texas PP counties. Categories with at least one entry denoted with * are significantly greater (p<0.01) than those not depicted with *. Those with + are statistically significant (p<0.05).  Figure 2: Racial breakdown of Texas PP counties  Figure 3: Population of NH Whites living in PP versus non-PP Texas counties  Figure 4: Population of Hispanics living in PP versus non-PP Texas counties  Figure 5: Population of NH Blacks living in PP versus non-PP Texas counties   Figure 8Figure 6 Figure 7Figures 6, 7, 8: Breakdown of incidence-adjusted Melanoma mortality in Texas PP counties by age, sex, and race, respectively. All entries denoted with * are significantly greater (p<0.01) than other entries not depicted with *. Those with + are statistically significant (p<0.05).  Figure 1: 2015 Map of U.S. Persistent Poverty Counties PP County Incidence-Adjusted Melanoma Mortality by RacePP County Incidence-Adjusted Melanoma Mortality by Age in Years PP County Incidence-Adjusted Melanoma Mortality by Sex

The Association Between Persistent Poverty and Melanoma Mortality in Texas: A Retrospective Study Using Texas Cancer Registry Data

https://openworks.mdanderson.org/cgi/viewcontent.cgi?article=1123&context=sumexp22

The Association Between Persistent Poverty and Melanoma Mortality in Texas: A Retrospective Study Using Texas Cancer Registry Data

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