TY - JOUR
T1 - Greater distance to an academic medical center is associated with poorer melanoma prognostic factors
T2 - The university of colorado experience
AU - Snyder, Blake M.
AU - Mounessa, Jessica S.
AU - Fazzari, Melissa
AU - Caravaglio, Joseph V.
AU - Kretowicz, Alexandra
AU - Braunberger, Taylor
AU - Wells, Keith
AU - Dunnick, Cory A.
AU - Dellavalle, Robert P.
AU - Alkousakis, Theodore
N1 - Publisher Copyright:
© 2017, Dermatology Online Journal. All rights reserved.
PY - 2017/11
Y1 - 2017/11
N2 - 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.
AB - 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.
KW - Breslow depth
KW - Malignant melanoma
KW - Melanoma
KW - Metastatic melanoma
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M3 - Article
C2 - 29447632
AN - SCOPUS:85037743431
SN - 1087-2108
VL - 23
JO - Dermatology Online Journal
JF - Dermatology Online Journal
IS - 11
M1 - 8
ER -