Greater distance to an academic medical center is associated with poorer melanoma prognostic factors: The university of colorado experience

Blake M. Snyder, Jessica S. Mounessa, Melissa Fazzari, Joseph V. Caravaglio, Alexandra Kretowicz, Taylor Braunberger, Keith Wells, Cory A. Dunnick, Robert P. Dellavalle, Theodore Alkousakis

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Introduction: Numerous studies report a correlation between distance to diagnostic provider in an academic medical center and poorer prognosis of disease. Limited research on this topic exists with respect to melanoma. Methods: This was a retrospective chart review of 1,463 adults (=18 years) initially diagnosed with melanoma between 2006-2016. Associations between distance traveled and Breslow depth and presence of metastatic disease were assessed via cumulative and binary logistic regression models, adjusting for patient and tumor characteristics. Results: Subjects traveling =50 miles had 58% greater odds of having an increased Breslow depth than those traveling less than that distance (OR: 1.58, 95% CI: 1.24-2.01, p<0.0001), and had four times the odds of presenting with metastatic disease (OR: 4.04, 95% CI: 3.00-5.46, p<0.0001). Discussion: We highlight the correlation between increased distance to our academic medical center with greater Breslow depths and the presence of metastatic disease at presentation. Conclusion: Future studies assessing other factors and regional differences that limit access to diagnosis might help improve screening efforts to prevent poorer prognosis for patients in these areas.

Original languageEnglish (US)
Article number8
JournalDermatology Online Journal
Volume23
Issue number11
StatePublished - Nov 2017
Externally publishedYes

Keywords

  • Breslow depth
  • Malignant melanoma
  • Melanoma
  • Metastatic melanoma

ASJC Scopus subject areas

  • Dermatology

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    Snyder, B. M., Mounessa, J. S., Fazzari, M., Caravaglio, J. V., Kretowicz, A., Braunberger, T., Wells, K., Dunnick, C. A., Dellavalle, R. P., & Alkousakis, T. (2017). Greater distance to an academic medical center is associated with poorer melanoma prognostic factors: The university of colorado experience. Dermatology Online Journal, 23(11), [8].