Aims
To evaluate the associations between patient’s socio-economic status and their location of residence, on melanoma stage at time of diagnosis.
Method
Patients with new histologically confirmed T1b-T4b melanoma in Queensland, Australia, were recruited between 2010-2014. Patients were assigned a Socio-Economic Index for Areas based on their postcode. Melanoma stage at diagnosis was divided into early tumour stage (T1b-T3a) and late tumour stage (T3b and above). We used adjusted logistic regression models to assess whether patient’s SEIFA score and/or their location of residence, were associated with tumour stage at time of melanoma diagnosis.
Results
Of 700 study participants, those with a lower social advantage score had a higher likelihood of presenting with a higher tumour stage at diagnosis, compared to patients from more advantaged areas (odds ratio [OR] = 1.67, 95% confidence interval [CI]: 1.13-2.47, p=0.01). Compared to patients from cities (n= 389), those from inner regional areas (n=209) were more likely to have a later stage melanoma (OR 1.52, 95% CI 1.00-2.30; P = 0.03). There was no difference in tumour stage at diagnosis when comparing patients from rural areas versus city dwellers (OR 0.89, 95% CI 0.49-1.62; P = 0.27).
Conclusions
Our study suggests that patients from higher socio-economic areas within Australia are more likely to be diagnosed with an earlier melanoma, compared to those from lower SES regions. Recognising differences in health status and outcomes at individual and community levels is essential for tackling health inequalities, effectively directing behavioural interventions, and policy change.