{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T09:58:20Z","timestamp":1785491900498,"version":"3.56.0"},"reference-count":71,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Melanoma accounts for nearly 8000 skin cancer-related deaths annually in the USA. Its impact on survival across intersectional sociodemographic factors remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To characterize relative survival rates (RSRs) in patients with melanoma stratified by various intersecting \u00adsociodemographic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective cohort study, relative survival analysis was conducted on patients with acral lentiginous (ALM), nodular (NM), superficial spreading (SSM) and lentigo maligna melanoma (LMM). Relative survival is advantageous as it compares survival in patients with cancer with the expected survival of individuals without cancer with matched characteristics to minimize noncancer mortality differences. This study utilized the Surveillance, Epidemiology, and End Results (SEER) database, established on cancer registries covering \u223c48% of the US population. Age-standardized 5-year RSRs and 95% log\u2013log confidence intervals (CIs) were calculated for each melanoma subtype for subgroups stratified by intersections of age, race, sex, marital status and Breslow thickness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All melanoma subtypes except LMM had significant survival reductions, with NM having the lowest RSR (73.5%, log\u2013log CI 72.7\u201374.3). ALM impacted survival most in male patients, followed by older populations, with younger male patients having lower RSRs than older female patients but younger female patients having similar survival to their counterparts without cancer. Male patients of all races or ethnicities other than White had lower RSRs than White male patients at every Breslow stage, whereas female patients had similar RSRs across all races or ethnicities. In NM, younger male patients had lower RSRs than younger female patients, but this difference narrowed with age. Asian and Black patients with NM experienced the most impact on survival. Patients with NM and SSM who were married had higher SSRs than patients who were not married. With regard to SSM and LMM, many age groups had RSRs of 100%; younger patients had slight but significant survival reductions. In SSM, Asian male patients had a particularly low RSR (85.9%), while other race\u2013sex subgroups had RSRs &amp;gt;94%, a pattern observed across all Breslow thicknesses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The impact of melanoma on survival is largest on older male patients with ALM of all races or ethnicities other than White; Asian, Black and older patients with NM; and Black female patients and Asian patients with SSM. White patients with all melanoma subtypes, older patients with SSM and LMM, and younger female patients with ALM and NM were the least affected. Our findings demonstrate the varying survival impact of melanoma on different subpopulations, underscoring the importance of investigating intersectional sociodemographic factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/skinhd\/vzag067","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T12:16:55Z","timestamp":1777637815000},"page":"539-549","source":"Crossref","is-referenced-by-count":0,"title":["Utilizing relative survival to investigate melanoma subtypes across intersectional demographics: a Surveillance, Epidemiology, and End Results (SEER) cohort study"],"prefix":"10.1093","volume":"6","author":[{"given":"Benjamin D","family":"Hu","sequence":"first","affiliation":[{"name":"Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai , New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2802-6969","authenticated-orcid":false,"given":"Brandon R","family":"Block","sequence":"additional","affiliation":[{"name":"Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai , New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Rabinowitz","sequence":"additional","affiliation":[{"name":"Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai , New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0402-7828","authenticated-orcid":false,"given":"Hannah","family":"Verma","sequence":"additional","affiliation":[{"name":"Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai , New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5175-959X","authenticated-orcid":false,"given":"Raphaella","family":"Lambert","sequence":"additional","affiliation":[{"name":"Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai , New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bragi","family":"Adalsteinsson","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Iceland , Reykjavik ,","place":["Iceland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f3n Gunnlaugur","family":"J\u00f3nasson","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Iceland , Reykjavik ,","place":["Iceland"]},{"name":"Department of Pathology, Landspitali \u2013 the National University Hospital of Iceland , Reykjavik ,","place":["Iceland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bardur","family":"Sigurgeirsson","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Iceland , Reykjavik ,","place":["Iceland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shane A","family":"Meehan","sequence":"additional","affiliation":[{"name":"Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai , New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Ungar","sequence":"additional","affiliation":[{"name":"Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai , New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse M","family":"Lewin","sequence":"additional","affiliation":[{"name":"Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai , New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Gulati","sequence":"additional","affiliation":[{"name":"Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai , New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas A","family":"Adalsteinsson","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Iceland , Reykjavik ,","place":["Iceland"]},{"name":"Department of Pathology, Landspitali \u2013 the National University Hospital of Iceland , Reykjavik ,","place":["Iceland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,9]]},"reference":[{"key":"2026073105092794800_vzag067-B1","doi-asserted-by":"crossref","DOI":"10.3390\/cancers13153866","article-title":"Age and cohort trends of malignant melanoma in the United States","volume":"13","author":"Lashway","year":"2021","journal-title":"Cancers (Basel)"},{"key":"2026073105092794800_vzag067-B2","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1001\/jamadermatol.2022.0160","article-title":"Global burden of cutaneous melanoma in 2020 and projections to 2040","volume":"158","author":"Arnold","year":"2022","journal-title":"JAMA Dermatol"},{"key":"2026073105092794800_vzag067-B3","doi-asserted-by":"crossref","first-page":"63","DOI":"10.3390\/medsci9040063","article-title":"Epidemiology of melanoma","volume":"9","author":"Saginala","year":"2021","journal-title":"Med Sci"},{"key":"2026073105092794800_vzag067-B4","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1111\/jdv.20386","article-title":"Declining invasive and rising in situ melanoma incidence trends in Iceland: a nationwide cohort study","volume":"39","author":"Thomas","year":"2024","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2026073105092794800_vzag067-B5","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.jaad.2010.11.016","article-title":"Systematic skin cancer screening in Northern Germany","volume":"66","author":"Breitbart","year":"2012","journal-title":"J Am Acad Dermatol"},{"key":"2026073105092794800_vzag067-B6","first-page":"3","article-title":"Melanoma awareness programs and their impact on the life of Australian Queenslanders: a concise analysis","volume":"18","author":"Rasheed","year":"2024","journal-title":"Int J Health Sci"},{"key":"2026073105092794800_vzag067-B7","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2015-008158","article-title":"Melanoma mortality following skin cancer screening in Germany","volume":"5","author":"Boniol","year":"2015","journal-title":"BMJ Open"},{"key":"2026073105092794800_vzag067-B8","doi-asserted-by":"crossref","first-page":"2759","DOI":"10.1007\/s00432-021-03562-1","article-title":"Multivariate analysis of prognostic factors in patients with nodular melanoma","volume":"147","author":"Susok","year":"2021","journal-title":"J\u00a0Cancer Res Clin Oncol"},{"key":"2026073105092794800_vzag067-B9","doi-asserted-by":"crossref","DOI":"10.1093\/jncics\/pkaa097","article-title":"Subtyping cutaneous melanoma matters","volume":"4","author":"El Sharouni","year":"2020","journal-title":"JNCI Cancer Spectr"},{"key":"2026073105092794800_vzag067-B10","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1177\/12034754211052866","article-title":"Racial differences in the prognosis and survival of cutaneous melanoma from 1990 to 2020 in North America: a systematic review and meta-analysis","volume":"26","author":"Lam","year":"2021","journal-title":"J\u00a0Cutan Med Surg"},{"key":"2026073105092794800_vzag067-B11","doi-asserted-by":"crossref","first-page":"1907","DOI":"10.1001\/archinte.166.17.1907","article-title":"Ethnic differences among patients with cutaneous melanoma","volume":"166","author":"Cormier","year":"2006","journal-title":"Arch Intern Med"},{"key":"2026073105092794800_vzag067-B12","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1016\/j.jaad.2020.03.094","article-title":"Racial differences in time to treatment for melanoma","volume":"83","author":"Tripathi","year":"2020","journal-title":"J Am Acad Dermatol"},{"key":"2026073105092794800_vzag067-B13","first-page":"101","article-title":"The relative survival rate: a statistical methodology","volume":"6","author":"Ederer","year":"1961","journal-title":"Natl Cancer Inst Monogr"},{"key":"2026073105092794800_vzag067-B14","doi-asserted-by":"crossref","first-page":"933","DOI":"10.2307\/2529873","article-title":"Cancer survival corrected for heterogeneity in patient withdrawal","volume":"38","author":"Hakulinen","year":"1982","journal-title":"Biometrics"},{"key":"2026073105092794800_vzag067-B15","first-page":"480","volume-title":"International Encyclopedia of Public Health","author":"Relative Survival \u2013 an overview. 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