Skip to main content
eScholarship
Open Access Publications from the University of California

Greater distance to an academic medical center is associated with poorer melanoma prognostic factors: The University of Colorado Experience

  • Author(s): Snyder, Blake M
  • Mounessa, Jessica S
  • Fazzari, Melissa
  • Caravaglio, Joseph V
  • Kretowicz, Alexandra
  • Braunberger, Taylor
  • Wells, Keith
  • Dunnick, Cory A
  • Dellavalle, Robert P
  • Alkousakis, Theodore
  • et al.
Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Public License
Abstract

Introduction: Numerous studies report a correlation between distance to diagnostic provider in an academic medical center and poorer prognosis ofdisease. 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 ofmetastatic 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.

Main Content
Current View