Factors Associated with Time to Surgery in Melanoma: An Analysis of the National Cancer Database Public

Baranowski, Marissa Lainey Harty (Spring 2019)

Permanent URL: https://etd.library.emory.edu/concern/etds/sx61dn372?locale=fr
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Abstract

Timely treatment for melanoma may affect survival and characterizing predictors of treatment delay may inform intervention strategies. The objective of this study was to determine patient- and facility-level characteristics associated with time to treatment in melanoma. The National Cancer Database was used to examine factors associated with the interval between diagnosis and definitive surgical treatment among 205,665 patients with Stage I, II, or III cutaneous melanoma.

Among privately insured patients, delay in surgical treatment was significantly associated with older age. By contrast, in patients without private insurance, the association with age was weaker and in the opposite direction. Other factors associated with a longer interval from diagnosis to surgery included non-white race, less education, higher comorbidity burden, more advanced stage, and head or neck melanoma location. Limitations include use of zip-code level data for patient income and education level. Melanoma patients experience disparities in timely receipt of surgery. 

Table of Contents

Introduction                                                                                                             

Methods                                                                                                                  

Results                                                                                                                       

Discussion                                                                                                           

References                                                                                                            

Figure 1.                                                                                                                    

“Flow Diagram Depicting Exclusions to Arrive at the Analytic Data Set”

Figure 2.                                                                                                                   

“Time to Definitive Surgical Procedure by Age Category”

Table 1.                                                                                                                    

Patient, Facility, and Disease Characteristics by Age Category”

Table 2.                                                                                                                   

“Factors Associated with Interval between Diagnosis to Definitive

Melanoma Surgery among Privately Insured Patients (n = 115,461)”

Table 3.                                                                                                                    

Factors Associated with Interval between Diagnosis to Definitive

Melanoma Surgery among Patients without a Private Insurance

(n = 90,204)”

Supplemental Table 1.                                                                                      

“Factors Associated with Interval between Diagnosis to Definitive

Melanoma Surgery among Privately Insured Patients 40 Years and

Older (n = 94,429)”

Supplemental Table 2.                                                                                           

“Factors Associated with Interval between Diagnosis to Definitive

Melanoma Surgery among Patients without a Private Insurance 40

Years and Older (n = 87,015)”

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