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Research ArticleClinical Studies

Treatment Contraindications Based on Comorbidity Status in Patients With Melanoma in the United States

DANIEL BOCZAR, SANJAY P. BAGARIA, AARON C. SPAULDING, MARIA T. HUAYLLANI, FRANCISCO R. AVILA, GUNEL GULIYEVA, XIAONA LU, BRIAN D. RINKER and ANTONIO J. FORTE
Anticancer Research April 2021, 41 (4) 2067-2070; DOI: https://doi.org/10.21873/anticanres.14976
DANIEL BOCZAR
1Division of Plastic Surgery, Mayo Clinic, Jacksonville, FL, U.S.A.;
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SANJAY P. BAGARIA
2Department of Surgery, Mayo Clinic, Jacksonville, FL, U.S.A.;
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AARON C. SPAULDING
3Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, FL, U.S.A.;
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MARIA T. HUAYLLANI
1Division of Plastic Surgery, Mayo Clinic, Jacksonville, FL, U.S.A.;
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FRANCISCO R. AVILA
1Division of Plastic Surgery, Mayo Clinic, Jacksonville, FL, U.S.A.;
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GUNEL GULIYEVA
1Division of Plastic Surgery, Mayo Clinic, Jacksonville, FL, U.S.A.;
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XIAONA LU
4Division of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT, U.S.A.
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BRIAN D. RINKER
1Division of Plastic Surgery, Mayo Clinic, Jacksonville, FL, U.S.A.;
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ANTONIO J. FORTE
1Division of Plastic Surgery, Mayo Clinic, Jacksonville, FL, U.S.A.;
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  • For correspondence: ajvforte@yahoo.com.br
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Abstract

Background/Aim: Melanoma incidence has increased in the United States over the past few decades, and disparities in patient treatment have been described. Although most patients with melanoma are good candidates for curative treatment, some are considered poor candidates for treatment because of comorbid conditions. We examined whether patient demographics influence treatment contraindication in melanoma. Patients and Methods: The National Cancer Database (NCDB) was used to identify patients with melanoma from 2004 through 2015. Multivariate logistic regression was used to determine independent associations, adjusted for confounders. We excluded patients who did not receive treatment for reasons and patients with unknown treatment status. Results: A total of 499,092 patients met the inclusion criteria. Of these, 525 (0.1%) had Treatment contraindicated because of comorbid conditions (TCBC) and 498,567 (99.9%) received treatment. Multivariate logistic regression showed higher odds of TCBC in patients with government insurance (OR=1.34, 95%CI=03-1.73; p=0.03) and patients without insurance (OR=2.75, 95%CI=1.76-4.29; p<0.001) than patients with private insurance. Conclusion: Demographic disparities affects treatment decision in oncological patients. Our study demonstrated a significantly higher likelihood of “nontreatment because of comorbid conditions” among melanoma patients with government insurance or without insurance. Greater efforts are needed to address inequalities in melanoma treatment in the United States.

Key Words:
  • Comorbidity
  • epidemiology
  • melanoma
  • National Cancer Database
  • treatment contraindications
  • United States
  • Received February 7, 2021.
  • Revision received February 24, 2021.
  • Accepted March 3, 2021.
  • Copyright © 2021 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.
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Anticancer Research: 41 (4)
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Treatment Contraindications Based on Comorbidity Status in Patients With Melanoma in the United States
DANIEL BOCZAR, SANJAY P. BAGARIA, AARON C. SPAULDING, MARIA T. HUAYLLANI, FRANCISCO R. AVILA, GUNEL GULIYEVA, XIAONA LU, BRIAN D. RINKER, ANTONIO J. FORTE
Anticancer Research Apr 2021, 41 (4) 2067-2070; DOI: 10.21873/anticanres.14976

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Treatment Contraindications Based on Comorbidity Status in Patients With Melanoma in the United States
DANIEL BOCZAR, SANJAY P. BAGARIA, AARON C. SPAULDING, MARIA T. HUAYLLANI, FRANCISCO R. AVILA, GUNEL GULIYEVA, XIAONA LU, BRIAN D. RINKER, ANTONIO J. FORTE
Anticancer Research Apr 2021, 41 (4) 2067-2070; DOI: 10.21873/anticanres.14976
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Keywords

  • comorbidity
  • epidemiology
  • melanoma
  • National Cancer Database
  • treatment contraindications
  • United States
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