The Melanoma Divide: Hispanic Health Disparities From Peru to the United States.

Abstract

Introduction: Melanoma is a heterogeneous malignancy, the incidence of which has increased by 20% in the Hispanic population over the past two decades. We aimed to compare the clinical, pathological, and outcome-related characteristics of Hispanic patients with melanoma in Peru (HPP) versus the United States (HPUS).

Methods: Two retrospective cohorts were evaluated: HPP diagnosed with melanoma at a tertiary institution in Lima-Peru and HPUS with melanoma registered in the Surveillance, Epidemiology, and End Results Program during the period 2010-2019.

Results: A total of 1136 HPP and 5302 HPUS were included. HPP patients were older (61.17 vs. 56.63 years, p < 0.001), more likely to be male (51.5% vs. 39.6%, p < 0.001), and resided in nonmetropolitan areas (49.6% vs. 3.5%, p < 0.001). HPP had a higher prevalence of primary lesions in the lower extremities (75.5% vs. 36.9%, p < 0.001) and ulceration (65.3% vs. 21.3%, p < 0.001). Histologically, HPP most commonly presented with acral lentiginous melanoma (38.1%), while HPUS had a more superficial spreading type (30.8%, p < 0.001). HPP showed greater Breslow depth (mean: 7.66 vs. 1.51 mm, p < 0.001) and mitotic activity and were diagnosed at more advanced stages: stage III (36.5% vs. 15.0%, p < 0.001). With a median follow-up of 74 months, HPP exhibited worse 5-year overall survival (OS) rates across all stages versus HPUS.

Conclusions: HPP with melanoma exhibit more aggressive pathological features than their HPUS counterparts and are diagnosed at more advanced stages, resulting in poorer OS rates across all stages, and being HPP is a prognostic factor of a worse OS. These findings emphasize the need for further research to deepen our understanding of the molecular factors influencing this diverse biological presentation in Hispanic populations.