Association of rurality and health professional shortages with the clinicopathologic characteristics of melanoma in North Carolina

Bibliographic Data

ID19431069
AuthorsMichael Seth Flynn (0000-0002-7941-1069, Department of Dermatology University of North Carolina Chapel Hill North Carolina USA), Matthew Gayed (Department of Dermatology Duke University Medical Center Durham North Carolina USA), Jamie Lebhar (0000-0002-5291-4424, Department of Dermatology Duke University Medical Center Durham North Carolina USA), Jennifer Jacobs (0000-0002-2300-4771, Department of Dermatology Duke University Medical Center Durham North Carolina USA), Christian Bailey‐Burke (0000-0002-3988-9519, Department of Dermatology Duke University Medical Center Durham North Carolina USA), Kristin A Tissera (0000-0003-0317-4156, Duke Medical Center), Kristin Tissera (Department of Dermatology Duke University Medical Center Durham North Carolina USA), Beiyu Liu (0000-0003-1455-0233, Department of Biostatistics and Bioinformatics Duke University Durham North Carolina USA), Cynthia Green (Department of Biostatistics and Bioinformatics Duke University Durham North Carolina USA), Cynthia L Green (0000-0002-0186-5191, Duke University), Michelle B Pavlis (Department of Dermatology Duke University Medical Center Durham North Carolina USA), Michelle Pavlis (Duke Medical Center), Paul J Mosca (0000-0003-3388-9013, Department of Surgery Duke University Medical Center Durham North Carolina USA, corresponding author)
Year2025
Volume41
Issue2
Pagese12881-e12881
Publication date2025-03-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueThe Journal of Rural Health (JOURNAL)
Journal identifiersISSN: 0890-765X • E-ISSN: 1748-0361
PublisherWiley (PUBLISHER • GB)
DOI10.1111/jrh.12881
PMID39363437
OpenAlexW4403143852
LanguageEN
References cited27

PURPOSE: To assess rural-urban and health professional shortage area (HPSA)-related influences on the characteristics of melanoma in North Carolina. METHODS: We conducted a single-center retrospective cohort study of patients living in North Carolina with an available pathology report for invasive cutaneous melanoma seen in the Duke University Health System from 01/01/2014 to 12/31/2020. Multivariable logistic regression models were employed to compare patient and tumor characteristics between rural versus urban county residence as well between melanoma thicknesses dichotomized into thin (≤1.0 mm) and thicker (>1.0 mm) tumors. FINDINGS: The cohort included 807 patients, and rural patients accounted for 177 (21.9%) of invasive cutaneous melanomas. Rural patients had significantly higher odds of having thicker tumors than urban patients (odds ratio [OR] = 1.78, 95% confidence interval [CI]: 1.17-2.71; P = .008). Rural patients were significantly more likely to be female (OR = 1.59, 95% CI: 1.10-2.28; P = .013) and located in a population-based (OR = 2.66, 95% CI: 1.84-3.84; P 1.0 mm in thickness, a clinically significant difference with important prognostic implications. Interventions at the county- and state-level to address this disparity may include improving access to skin cancer screening and teledermatology programs, increasing partnerships with primary care providers, and targeting interventions to counties with health professional shortages

Cohort · Cohort study · Confidence interval · Environmental health · Logistic regression · Odds · Odds ratio · Pathology · Population · Residence · Retrospective cohort study · Rural area · Rurality · Cutaneous Melanoma Detection and Management · Demography · Diversity and Career in Medicine · Economic and Financial Impacts of Cancer · Medicine · Internal Medicine