Understanding Metastatic Melanoma in People of Color: Key Insights and Prevention Tips

Melanoma diagnosis in people of color frequently occurs at more advanced stages, leading to lower survival rates compared to white individuals. This disparity stems from limited awareness about melanoma risks and insufficient representation in medical research.

Melanoma is a serious skin cancer originating from melanocytes, the pigment-producing cells in the skin. While ultraviolet (UV) radiation exposure is a common cause, genetic mutations unrelated to sun exposure can also trigger melanoma.

Individuals with lighter skin tones face a higher melanoma risk, especially those with light hair and eye colors. Despite a lower overall incidence among people of color, they experience worse outcomes and are more often diagnosed with advanced melanoma.

What Is Metastatic Melanoma and Its Impact on People of Color?

Metastatic melanoma refers to stage 4 melanoma, where cancer cells have spread beyond their original site to distant parts of the body. According to the Melanoma Research Alliance, people of color are four times more likely to be diagnosed at this advanced stage and have a 1.5 times higher mortality rate than white individuals.

• Black patients with melanoma have a 5-year survival rate of approximately 71%, compared to 94% among white patients.
• Melanomas in people of color often develop in less sun-exposed areas such as the soles of the feet, palms, and nail regions.
• Up to 75% of melanomas in people of color appear on these atypical sites.

Why Is Melanoma Less Common but More Severe in People of Color?

Darker skin contains higher melanin levels, which provide natural protection against UV radiation, reducing melanoma risk. This protective pigment absorbs and neutralizes harmful UV rays, making sunburns less common among people with darker skin.

However, this protection can lead to underestimation of melanoma risk, causing delays in diagnosis and treatment. Additionally, melanoma in people of color often presents in locations not typically associated with sun exposure, complicating early detection.

Factors Contributing to Disparities in Metastatic Melanoma

Limited Awareness of Risk

Many people of color may not recognize their susceptibility to melanoma, resulting in less frequent use of sun protection and delayed medical consultation.

Distinct Clinical Presentation

Melanoma in people of color tends to appear on the underside of hands and feet or around nails, areas less commonly affected in white populations. These atypical presentations may be mistaken for benign conditions, delaying diagnosis.

Insufficient Inclusive Research

A 2023 study highlights that lack of diverse representation in melanoma research contributes to gaps in knowledge and education, leading to missed or late diagnoses in people of color.

Health Inequities

Systemic barriers such as limited healthcare access, language challenges, socioeconomic factors, and discrimination further hinder timely diagnosis and treatment for metastatic melanoma in communities of color.

Strategies to Address Melanoma Disparities

Reducing metastatic melanoma disparities requires comprehensive efforts including:

• Expanding inclusive research and clinical trials
• Enhancing dermatology training focused on diverse skin types
• Launching community-based melanoma awareness programs
• Implementing policy reforms to improve healthcare access and equity
• Providing cultural competency training for healthcare providers

Preventive Measures for People of Color

Regardless of skin tone, everyone can lower melanoma risk by following these guidelines recommended by the American Academy of Dermatology Association:

• Avoid tanning beds and sunlamps
• Wear protective clothing, including coverage for feet and hands
• Seek shade during peak sun hours
• Apply broad-spectrum, water-resistant sunscreen with SPF 30 or higher 15–30 minutes before sun exposure
• Reapply sunscreen every two hours or after swimming or sweating
• Perform monthly full-body skin self-examinations to detect any new or changing spots

Consult a dermatologist promptly if you notice:

• Changes in existing moles or new growths
• Dry, scaly patches
• Dark streaks near or under nails
• Sores that do not heal or recur
• Bleeding or itching associated with skin lesions

Summary

Melanoma affects all skin types, but people of color often face diagnosis at more advanced stages, resulting in poorer outcomes. Raising awareness, promoting inclusive research, and addressing health inequities are essential to improving melanoma detection and treatment in diverse populations.

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