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TOPLINE:

Regions in the US with more dermatologists had lower proportions of late-stage melanoma diagnoses from 2017 to 2021 in a national ecological study.

METHODOLOGY:

• A cross-sectional ecological study of 557 National Cancer Institute Health Service Areas (HSAs) analyzed data from the US Department of Health and Human Services State Cancer Profiles from 2017 to 2021.
• The median HSA demographics comprised 49.7% men, with 18.0% aged > 65 years; 79.8% were White, 6.3% Hispanic, and 4.9% Black individuals.
• Dermatologist density was categorized into five strata ranging from 0 to > 4 dermatologists per 100,000 population.
• The primary outcome was late-stage melanoma diagnosis, defined as regional or distant disease at the HSA level.

TAKEAWAY:

• Overall, the median HSA dermatologist density was 1.97 per 100,000, and the median proportion of melanoma cases diagnosed at a late stage was 15.6%.
• Compared with HSAs with no dermatologists, odds of late-stage melanoma diagnoses were reduced by 11% for HSA levels > 0-1 (OR, 0.89, P = .032) and > 1-2 (OR, 0.89, P = .017); 16% for HSA levels > 2-4 (OR, 0.84; P < .001), and 20% for HSA levels > 4 (OR, 0.80, P < .001) dermatologists per 100,000 population.
• Higher educational attainment (OR, 0.99; P < .001 for each 1% increase in bachelor’s degree attainment) and insurance coverage (OR, 0.99; P = .017 with every 1% increase) were linked to lower odds of late-stage melanoma diagnosis.
• Each 1% increase in White (OR, 1.004; P = .035) or Hispanic (OR, 1.005; P = .007) residents was associated with slightly higher odds of late-stage melanoma incidence.

IN PRACTICE:

“In this national ecological study, higher dermatologist density was associated with a lower proportion of melanoma cases diagnosed at a late stage,” the authors wrote. “These findings suggest that greater access to dermatologic care may facilitate earlier melanoma detection at the population level,” they added, noting that expanding the dermatology workforce in underserved regions “may represent an important strategy to reduce disparities in melanoma stage at diagnosis.” 

SOURCE:

The study was led by Eli Kasheri, University of Miami Miller School of Medicine, Miami, and was published online on May 16 in the Journal of the American Academy of Dermatology.

LIMITATIONS:

The analysis was ecological and therefore could not establish causation or individual‑level associations. Workforce data captured only board‑certified dermatologists and did not account for teledermatology or advanced practice providers, nor did it distinguish cosmetic‑only practitioners. Additionally, many HSAs were excluded because of data suppression, resulting in underrepresentation of rural and disadvantaged areas.

DISCLOSURES:

The study did not receive any specific funding. The authors disclosed having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.