Facilitators and Barriers to the Timely Diagnosis and Treatment of Melanoma in Latino Persons.

IF 11 1区医学 Q1 DERMATOLOGY

JAMA dermatology Pub Date : 2025-10-01 DOI:10.1001/jamadermatol.2025.3620

Kimberly A Miller, Priscilla Marìn, Rosario Aguero, Guillermo Muñoz, Marlene Caldera, Jennifer B Unger, Ashley B Crew, Fumito Ito, Lourdes Baezconde-Garbanati, Myles G Cockburn

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引用次数: 0

Abstract

Importance: While mortality from melanoma has decreased in non-Hispanic White individuals over the last decade due to new and effective therapies, disparities in survival remain for Latino populations. Latino patients have lower overall incidence of melanoma than non-Hispanic White patients but are more likely to be diagnosed with thicker, more advanced tumors, leading to higher mortality.

Objective: To identify the facilitators and barriers Latino patients face prior to melanoma diagnosis and treatment and to inform strategies that expedite care and improve survival rates in this population.

Design, setting, and participants: This qualitative study used reflexive thematic analysis of interviews with Latino patients with melanoma of any stage at diagnosis conducted in Los Angeles County, California, between May and November 2023. Patients were identified from the California Cancer Registry, part of the Surveillance, Epidemiology, and End Results Program.

Main outcomes and measures: A semistructured interview guide designed to explore multiple themes related to potential barriers and facilitators to timely diagnosis of melanoma among Latino patients.

Results: Of 20 included Latino patients with melanoma, 13 (65%) were female, and the median (range) age was 56.5 (41-79) years. Half of the interviews were conducted in Spanish, and 15 participants (75%) were diagnosed at an early stage (in situ or regional). A total of 6 themes were identified: 2 facilitators, including patients as advocates for their health care and linguistically appropriate care, and 4 barriers, including barriers to timely care due to health insurance procedures, delays in accessing specialty referral, low awareness of melanoma prior to diagnosis, and a lack of linguistically appropriate care.

Conclusions and relevance: This qualitative study identified multifaceted challenges faced by Latino patients as they seek both diagnosis and treatment of melanoma. Findings suggest several recommendations to accelerate time to diagnosis and prompt initiation of treatment to reduce disparities experienced by this patient population.

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拉丁美洲人黑色素瘤及时诊断和治疗的促进因素和障碍。

重要性：在过去的十年中，由于新的和有效的治疗方法，非西班牙裔白人黑色素瘤的死亡率有所下降，但拉丁裔人群的存活率仍然存在差异。拉丁裔患者的黑色素瘤总体发病率低于非西班牙裔白人患者，但更有可能被诊断为更厚、更晚期的肿瘤，从而导致更高的死亡率。目的：确定拉丁裔患者在黑色素瘤诊断和治疗前面临的促进因素和障碍，并告知加快护理和提高该人群生存率的策略。设计、环境和参与者：本定性研究对2023年5月至11月在加利福尼亚州洛杉矶县进行的诊断为任何阶段的拉丁裔黑色素瘤患者的访谈进行了反身性主题分析。患者从加州癌症登记处确定，这是监测、流行病学和最终结果计划的一部分。主要结果和措施：半结构化访谈指南，旨在探讨拉丁裔患者黑色素瘤及时诊断的潜在障碍和促进因素的多个主题。结果：纳入的20例拉丁裔黑色素瘤患者中，13例（65%）为女性，中位（范围）年龄为56.5岁（41-79）岁。一半的访谈以西班牙语进行，15名参与者（75%）在早期阶段（原位或区域）被诊断出来。共确定了6个主题：2个促进因素，包括患者作为其卫生保健和语言适当护理的倡导者；4个障碍，包括由于健康保险程序、获得专科转诊的延误、诊断前对黑色素瘤的认识较低以及缺乏语言适当护理而导致的及时护理障碍。结论和相关性：本定性研究确定了拉丁裔患者在寻求黑色素瘤诊断和治疗时面临的多方面挑战。研究结果提出了几项建议，以加快诊断时间和迅速开始治疗，以减少这一患者群体所经历的差异。

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来源期刊

JAMA dermatology DERMATOLOGY-

CiteScore

14.10

自引率

5.50%

发文量

300

期刊介绍： JAMA Dermatology is an international peer-reviewed journal that has been in continuous publication since 1882. It began publication by the American Medical Association in 1920 as Archives of Dermatology and Syphilology. The journal publishes material that helps in the development and testing of the effectiveness of diagnosis and treatment in medical and surgical dermatology, pediatric and geriatric dermatology, and oncologic and aesthetic dermatologic surgery. JAMA Dermatology is a member of the JAMA Network, a consortium of peer-reviewed, general medical and specialty publications. It is published online weekly, every Wednesday, and in 12 print/online issues a year. The mission of the journal is to elevate the art and science of health and diseases of skin, hair, nails, and mucous membranes, and their treatment, with the aim of enabling dermatologists to deliver evidence-based, high-value medical and surgical dermatologic care. The journal publishes a broad range of innovative studies and trials that shift research and clinical practice paradigms, expand the understanding of the burden of dermatologic diseases and key outcomes, improve the practice of dermatology, and ensure equitable care to all patients. It also features research and opinion examining ethical, moral, socioeconomic, educational, and political issues relevant to dermatologists, aiming to enable ongoing improvement to the workforce, scope of practice, and the training of future dermatologists. JAMA Dermatology aims to be a leader in developing initiatives to improve diversity, equity, and inclusion within the specialty and within dermatology medical publishing.