Aims
Our purpose was to evaluate the associations between patient’s socio-economic status (SES) and their location of residence, on melanoma stage at time of diagnosis. We hypothesise that lower levels of social advantage and/or living in remote or rural areas of Queensland, may delay melanoma diagnosis.
Methodology
Patients with newly diagnosed, histologically confirmed T1b to T4b melanoma in Queensland, Australia, were recruited between 2010 and 2014. Patients were assigned a Socio-Economic Index for Areas (SEIFA score, Australia 2011) based on their postcode, where a higher SEIFA score correlates with higher socio-economic advantage. Melanoma stage at diagnosis was divided into early tumour stage (T1b-T3a) and later 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 the 700 study participants, those in areas with lower social advantage had a higher likelihood of presenting with a higher tumour stage at diagnosis compared to patients in 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 residing in 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.