The Impact of Socioeconomic Status on the Incidence and Stage of Melanoma in China: A Single-Center Observational Study

Shaoluan Zheng; Jia Feng; Zhiwei Chen; Chuanyuan Wei; Yuyan Pan; Jiaqi Liu

doi:10.1097/SAP.0000000000003925

The Impact of Socioeconomic Status on the Incidence and Stage of Melanoma in China: A Single-Center Observational Study

Ann Plast Surg. 2024 May 7. doi: 10.1097/SAP.0000000000003925. Online ahead of print.

Authors

Shaoluan Zheng¹, Jia Feng², Zhiwei Chen³, Chuanyuan Wei², Yuyan Pan², Jiaqi Liu

Affiliations

¹ From the Plastic and Reconstructive Surgery, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen.
² Plastic and Reconstructive Surgery, Zhongshan Hospital, Fudan University, Shanghai.
³ Artificial Intelligence Center for Plastic Surgery and Cutaneous Soft Tissue Cancers, Zhongshan Hospital, Fudan University, Shanghai, China.

PMID: 38718342
DOI: 10.1097/SAP.0000000000003925

Abstract

Background: The role of high socioeconomic status (SES) as an established risk factor for melanoma has been well documented in Western countries and regions. However, research on the association between melanoma and SES in China remains limited. This study aimed to investigate the association between SES and melanoma incidence and stage in China.

Methods: Five measures of SES were accessed, including education level, ethnic background, per capita household income, occupation, and medical insurance coverage. A scoring system based on the Kuppuswamy Socio-Economic Scale was used to create a quantitative assessment of SES. To improve clarity and precision, we refined the language in the original text. Clinical stage at diagnosis was classified according to the Chinese Society Oncology Melanoma Guidelines.

Results: A total of 122 patients with pathologic melanoma were enrolled in this study from January 2013 to December 2017. Of these patients, 58 (48%) were male and 64 (52%) were female, with a mean age of 59.23 ± 9.91 years. Patients in the age groups of 45-59 and 60-73 had a higher incidence of melanoma compared to other age groups. Acral lentiginous melanoma was the most commonly observed subtype, accounting for 48% of cases. Patients with a low level of education (middle school and below) and a low level of monthly household income (<3000 CNY) had a higher risk of developing melanoma, as did those who were unemployed. Interestingly, a higher proportion of melanoma diagnoses were made in patients with medical insurance than those without. However, no significant differences in melanoma staging were found based on education level (P = 0.153), monthly household income (P = 0.507), occupation (P = 0.687), or insurance status (P = 0.537). According to the Kuppuswamy Socio-Economic Scale, there were 0 in upper class, 50 in upper middle class, 44 in lower middle class, 28 in upper lower class, 0 in lower class. The mean K-score was 13.85. No statistically significant interaction was observed between K-score and tumor stage.

Conclusions: Patients with lower SES have a higher risk of developing melanoma. However, no significant differences were found in melanoma staging based on SES.