有限的数据描述了肢端浅色黑色素瘤(ALM)的流行病学和危险因素。在这个回顾性分析中,我们研究了种族和族裔人口中ALM的发病率和死亡率趋势.我们询问了22个监控,流行病学,和西班牙裔ALM病例的最终结果登记册,非西班牙裔亚洲人或太平洋岛民(NHAPI),非西班牙裔黑人(NHB),和从2000年到2020年的非西班牙裔白人(NHW)。估计了年龄调整后的发病率和年度百分比变化(APC)。Kaplan-Meier曲线按种族和种族分层,并与对数秩检验进行比较。Cox比例风险回归模型根据年龄进行了调整,性别,种族,种族,收入,城乡住宅,舞台,和治疗。在4188例具有完整数据的ALM病例中,我们的研究队列包括792名(18.9%)西班牙裔,274(6.5%)NHAPI,336(8.0%)NHB,和2786(66.5%)NHWs。从2000年到2020年,年龄调整后的ALM发病率每年增加2.48%(P<0.0001),这是由西班牙裔美国人的发病率上升(APC2.34%,P=0.001)和NHW(APC2.69%,P<0.0001)。NHB的发病率保持稳定(APC1.15%,P=0.1)和NHAPIs(APC1.12%,P=0.4)。从2000年到2020年,765例(18.3%)患者死于ALM。与NHW相比,西班牙裔,NHAPI,和NHB显著增加了ALM特异性死亡率(所有P<0.0001)。未经调整和调整的原因特异性死亡率模型显示,西班牙裔美国人中ALM特异性死亡率的风险显着升高(风险比[HR]1.46,95%置信区间[CI]1.22-1.75;调整后的风险比[aHR]1.38,95%CI1.14-1.66),NHAPI(HR1.80,95%CI1.41-2.32;aHR1.58,95%CI1.23-2.04),和NHB(HR1.98,95%CI1.59-2.47;aHR2.19,95%CI1.74-2.76)(所有P<0.001)。我们的研究发现,西班牙裔和NHW人群中ALM的发病率上升,种族和族裔人口中ALM特异性死亡率的风险也升高。有必要采取未来的策略来减轻ALM中的健康不平等。
Limited data describe the epidemiology and risk factors of acral lentiginous melanoma (ALM). In this retrospective analysis, we examined trends in incidence and mortality of ALM among racial and ethnic minoritized populations. We queried 22 Surveillance, Epidemiology, and End Results registries for cases of ALM among Hispanics, non-Hispanic Asians or Pacific Islanders (NHAPIs), non-Hispanic Blacks (NHBs), and non-Hispanic Whites (NHWs) from 2000 through 2020. Age-adjusted incidence and annual percentage changes (APCs) were estimated. Kaplan-Meier curves were stratified by race and ethnicity and compared with log-rank tests. Cox proportional hazard regression models were adjusted for age, sex, race, ethnicity, income, urban-rural residence, stage, and treatment. Of 4188 total cases of ALM with complete data, our study cohort was comprised of 792 (18.9%) Hispanics, 274 (6.5%) NHAPIs, 336 (8.0%) NHBs, and 2786 (66.5%) NHWs. The age-adjusted incidence of ALM increased by 2.48% (P < 0.0001) annually from 2000 to 2020, which was driven by rising rates among Hispanics (APC 2.34%, P = 0.001) and NHWs (APC 2.69%, P < 0.0001). Incidence remained stable among NHBs (APC 1.15%, P = 0.1) and NHAPIs (APC 1.12%, P = 0.4). From 2000 through 2020, 765 (18.3%) patients died from ALM. Compared to NHWs, Hispanics, NHAPIs, and NHBs had significantly increased ALM-specific mortality (all P < 0.0001). Unadjusted and adjusted cause-specific mortality modeling revealed significantly elevated risk of ALM-specific mortality among Hispanics (hazard ratio [HR] 1.46, 95% confidence interval [CI] 1.22-1.75; adjusted hazard ratio [aHR] 1.38, 95% CI 1.14-1.66), NHAPIs (HR 1.80, 95% CI 1.41-2.32; aHR 1.58, 95% CI 1.23-2.04), and NHBs (HR 1.98, 95% CI 1.59-2.47; aHR 2.19, 95% CI 1.74-2.76) (all P < 0.001). Our study finds rising incidence of ALM among Hispanics and NHWs along with elevated risk of ALM-specific mortality among racial and ethnic minoritized populations. Future strategies to mitigate health inequities in ALM are warranted.