• Posted July 12, 2023

Melanoma an Even More Deadly Disease in Black Men

Black men are more likely to die of melanoma, new research shows, and one reason why may be the unusual places where the deadly skin cancer is likely to show up on their bodies.

Even though the disease is more common in white men, the new report shows that Black men are 26% more likely to die from it, the Washington Post reported.

"The purpose of our study was to dive deeper into why we are seeing these differences in survival rates and the factors that may be driving this,"study co-author Ashley Wysong, chair of dermatology at the University of Nebraska Medical Center, told the Post.

The researchers analyzed more than 205,000 cases and discovered that melanoma in Black men is often found in areas that have not had a lot of sun exposure, including the soles of the feet, toes, toenails, fingernails, fingernail beds and palms, the Post reported.

About 51% of Black men with melanoma have it on their lower extremities. In white men, only about 10% of those with melanoma have it on their lower extremities, while 35.5% have it on their trunk and nearly 26% have it on their head and neck, the study found. Only about 13% of cases in Black men were on the trunk and just under 10% were on the head.

"I think this is significant,"Ali Hendi, a specialist in skin cancer surgery in Chevy Chase, Md., told the Post. "This study doesn't give us the answer as to why, but it sheds light on the numbers."

Black men also tended to be diagnosed later, with nearly 49% diagnosed at late stages of the disease. Just over 21% of white men are diagnosed with late-stage disease, as are about 40% of Hispanic men, 38% of Asian men and 29% of Native American men, the study found.

The findings were published July 11 in the Journal of the American Academy of Dermatology.

The five-year survival rate of melanoma is 99% when the cancer is found early, but it's only 32% after it has spread, the Post reported.

That plays out in outcomes, with more than 75% of white men living for five years after diagnosis compared to about 52% of Black men, the study found.

The researchers found that about 20% of Black melanoma patients had a deadlier subtype found on the sole of the foot or palm of the hand that is called Acral lentiginous melanoma. Fewer than 1% of white men had this subtype.

"It's not related to sun exposure,"Robert Brodell, a professor of pathology and dermatology at the University of Mississippi Medical Center, told the Post. "It seems to have a different natural history, and a poorer prognosis, though late diagnosis is a component of that."

Wysong noted that melanomas on places like fingers, toes, palms and soles of feet can be mistaken for warts and fungus.

"Most people don't think of skin cancers in their nails or on their hands and feet,"Wysong said. "So we see delays in diagnosis because of the location. It's hard to see. Most people don't know what a nail melanoma looks like."

These cancers can look like a black dot under a fingernail, Brodell said.

Overall, invasive melanoma cases are up by 27% in 10 years, the Post reported. In 2023, there were over 97,000 cases in the United States, more than 58,000 in men. Nearly 8,000 people are expected to die of melanoma this year.

More education is needed for doctors and patients, including in Black patients where it rarely occurs, Jeremy Brauer, a clinical associate professor of dermatology at NYU Langone Health, told the Post.

Doctors may not be aware of the differences, Brauer said.

"This disproportionate and unfortunate rate of death means we have to try to be much more preventative,"Brauer said.

More information

The American Cancer Society has more on melanoma skin cancer.

SOURCES: Journal of the American Academy of Dermatology, July 11, 2023; Washington Post