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Even though melanoma is more common among white men, Black men who develop this type of cancer are much more likely to die than people from other racial and ethnic groups, a new study suggests.
For the study, published in the Journal of the American Academy of Dermatology, scientists examined data on more than 205,000 men diagnosed with melanoma from 2004 to 2018. The five-year survival rate was lowest for Black men, at about 52 percent, and highest for white men, at roughly 75 percent. This translates into a 26 higher risk of death for Black men than for white men, researchers calculated.
“This is likely due to the fact that melanoma in Black men is far less likely than in white men,” says Ali Hendi, MD, a dermatologist, skin cancer surgeon, and clinical assistant professor at Georgetown University Hospital in Washington, DC, who wasn’t involved in the study.
“For this reason, it is not on the radar of physicians and patients alike,” Dr. Hendi says.
All Men of Color With Melanoma Fare Worse Than White Men
In the United States, white men have the highest incidence rates of melanoma and Black women have the lowest incidence rates, according to the Centers for Disease Control and Prevention (CDC).
Overall, the study found five-year survival rates varied substantially by race, with all men of color faring worse than white men. Five-year survival rates from melanoma were 66 percent for Hispanic men, 68 percent for Asian men, and 69 percent for American Indian/Alaskan Native men.
In addition, scientists found differences in where melanoma appeared on the body: White and American Indian/Alaskan Native men were more apt to have these tumors found on the trunks of their bodies, while Black, Hispanic, and Asian men were more likely to have melanoma diagnosed on their lower extremities that aren’t exposed to the sun as often, and in unusual places like the skin between their fingers or toes.
Beyond this, the study also found that Black, Hispanic, and Asian men are more likely than white men to have melanoma diagnosed when cancer is more advanced and harder to treat.
“It is widely known in our specialty that, although less common, minorities are often diagnosed at a later stage when they get melanoma,” Hendi says. “Access to care may play a role.”
Even When Diagnosed at an Early Stage, Black Men Face Higher Melanoma Risks
The study wasn’t a controlled experiment designed to prove whether or how race or ethnicity might directly influence the odds of developing or dying from melanoma.
Still, Black men fared worse than white men even for melanomas diagnosed at the same stage, when outcomes should in theory be similar. This suggests that other factors — such as access to care or social or cultural perceptions about skin protection or cancer screening — might play a role, says Robert Brodell, MD, a professor and chair of pathology at the University of Mississippi Medical Center in Jackson who wasn’t involved in the study.
White people also tend to get types of melanoma that are caused by sun exposure, and types that grow sideways across the surface of the skin, which are easier to spot and treat before they spread, Dr. Brodell says.
“The kind of melanoma that is found in Black patients may have a uniquely worse prognosis than the common kind found in white people,” Brodell adds. ”And even when Black men get melanoma that should be easier to spot and treat earlier, dark discoloration that’s a hallmark of early-stage melanoma may not be as visible on Black skin,” Brodell says.
What Are the Signs of Skin Cancer?
Universal skin cancer screening isn’t recommended in the United States, per the U.S. Preventive Services Task Force, although certain high-risk individuals — including people with unexplained discolorations on their skin or a history of precancerous spots — should still get regular skin checks.
The American Academy of Dermatology does recommend self-skin exams to look for melanoma, and offers the following “ABCDE” tips for identifying changes on the skin that should be looked at by a doctor:
- Asymmetry One half of the spot is unlike the other half.
- Border The spot has an irregular, scalloped, or poorly defined border.
- Color The spot has varying colors from one area to the next, such as shades of tan, brown, or black, or areas of white, red, or blue.
- Diameter Melanomas are usually greater than 6 millimeters, or about the size of a pencil eraser.
- Evolving The spot looks different from the rest or is changing in size, shape, or color.
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