{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T16:37:01Z","timestamp":1784047021898,"version":"3.55.0"},"reference-count":15,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T00:00:00Z","timestamp":1712707200000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006975","name":"Indiana Clinical and Translational Sciences Institute","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/100006975","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Research from across the United States has shown that rurality is associated with worse melanoma outcomes. In Indiana, nearly a quarter of all residents live in rural counties and an estimated 2180 cases of melanoma will be diagnosed in 2023.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>This study examines how geographical location affects the stage of melanoma diagnosis in Indiana, aiming to identify and address rural health disparities to ultimately ensure equitable care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>Demographics and disease characteristics of patients diagnosed with melanoma at Indiana University Health from January 2017 to September 2022 were compared using Students <jats:italic>t<\/jats:italic>\u2010tests, Wilcoxon tests, chi\u2010squared or Fisher's exact tests. Patients from rural areas presented with more pathological stage T3 melanomas (15.0% vs. 3.5%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) in contrast to their urban counterparts. Additionally, rural patients presented with fewer clinical stage I melanomas (80.8% vs. 89.3%) and more clinical stage II melanomas (19.2% vs. 8.1%), compared to urban patients, with no stage III (<jats:italic>p<\/jats:italic>\u2009=\u20090.028). Concerningly, a significantly higher percentage of the rural group (40.7%) had a personal history of BCC compared to the urban group (22.6%) (<jats:italic>p<\/jats:italic>\u2009=\u20090.005) and fewer rural patients (78.0%) compared to urban patients (89.4%) received surgical treatment (<jats:italic>p<\/jats:italic>\u2009=\u20090.016).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients from rural counties in Indiana have higher pathological and clinical stage melanoma at diagnosis compared to patients from urban counties. Additionally fewer rural patients receive surgical treatment and may be at higher risk of developing subsequent melanomas.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cnr2.2072","type":"journal-article","created":{"date-parts":[[2024,4,11]],"date-time":"2024-04-11T02:59:10Z","timestamp":1712804350000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The influence of rurality on melanoma diagnosis in Indiana: A retrospective cohort study"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3689-3149","authenticated-orcid":false,"given":"Gloria R.","family":"Xue","sequence":"first","affiliation":[{"name":"Department of Dermatology Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Clark","sequence":"additional","affiliation":[{"name":"Department of Dermatology Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Morr","sequence":"additional","affiliation":[{"name":"Department of Dermatology Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James E.","family":"Slaven","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Health Data Science Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syril Keena T.","family":"Que","sequence":"additional","affiliation":[{"name":"Department of Dermatology Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,10]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/cnr2.1713"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.2217\/mmt\u20102020\u20100023"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2023.02.057"},{"key":"e_1_2_11_5_1","volume-title":"United States Department of Agriculture","author":"USDA Economic Research Service","year":"2022"},{"key":"e_1_2_11_6_1","unstructured":"ACS Cancer Statistics Center.Indiana: American Cancer Society.2023https:\/\/cancerstatisticscenter.cancer.org\/#!\/"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2008.11.418"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2020.08.092"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2023.3256"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/00031348231216485"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2021.666528"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.2340\/actadv.v103.4402"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2021.3884"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2017.07.050"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/archdermatol.2011.345"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/CEJ.0000000000000747"}],"container-title":["Cancer Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cnr2.2072","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,26]],"date-time":"2024-04-26T03:34:00Z","timestamp":1714102440000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cnr2.2072"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4]]},"references-count":15,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1002\/cnr2.2072"],"URL":"https:\/\/doi.org\/10.1002\/cnr2.2072","archive":["Portico"],"relation":{},"ISSN":["2573-8348","2573-8348"],"issn-type":[{"value":"2573-8348","type":"print"},{"value":"2573-8348","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4]]},"assertion":[{"value":"2023-10-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e2072"}}