{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T06:36:11Z","timestamp":1787726171834,"version":"build-2784847793"},"reference-count":26,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2019,5,12]],"date-time":"2019-05-12T00:00:00Z","timestamp":1557619200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Cutan Med Surg"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>When diagnosed at stage 0-I, melanoma has a 5-year survival rate of 92% to 100% in comparison with stage IV, which has a 5-year survival rate of 15% to 20%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The objective of this article is to identify what socioeconomic and demographic factors were associated with increased odds in receiving a delayed melanoma diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This study analyzed the odds of 108,628 patients from the National Cancer Database who were diagnosed between 2004 and 2012 with American Joint Committee on Cancer stage 0-I and stage IV based on race, sex, insurance type, income, facility type, and education.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We identified significantly ( P &lt; .05) increased odds of stage IV primary melanoma diagnosis in those who had nonprivate insurance, including Medicare (odds ratio [OR] = 1.31, 95% confidence interval [CI]: 1.19-1.45), other government insurance (OR = 2.19, 95% CI: 1.61-2.98), Medicaid (OR = 6.97, 95% CI: 5.98-8.13), or no insurance (OR = 5.10, 95% CI: 4.41-5.91). Increased odds of late-stage melanoma were also associated with male sex (OR = 1.46, 95% CI: 1.36-1.57), race and ethnicity other than non-Hispanic white such as Hispanic whites (OR = 1.49, 95% CI: 1.15-1.92) or African Americans (OR=4.81, 95% CI: 3.75-6.18), and who had decreased education (OR = 1.19, 95% CI: 1.09-1.30). There was not a significant increase in odds of late-stage melanoma in patients from areas with the lowest levels of income compared with areas of highest income.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Certain socioeconomic and demographic factors are associated with odds of a later-stage melanoma diagnosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1203475419847955","type":"journal-article","created":{"date-parts":[[2019,5,13]],"date-time":"2019-05-13T02:20:04Z","timestamp":1557714004000},"page":"421-427","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["The Odds of Stage IV Melanoma Diagnoses Based on Socioeconomic Factors"],"prefix":"10.1177","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3873-4272","authenticated-orcid":false,"given":"Mary","family":"Dick","sequence":"first","affiliation":[{"name":"Creighton School of Medicine, Omaha, NE, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Aurit","sequence":"additional","affiliation":[{"name":"Clinical Research and Evaluative Sciences at CHI Health Creighton University Medical Center, Omaha, NE, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Silberstein","sequence":"additional","affiliation":[{"name":"Hematology Oncology at CHI Health Creighton University Medical Center Omaha, NE, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,5,12]]},"reference":[{"key":"bibr2-1203475419847955","doi-asserted-by":"publisher","DOI":"10.1038\/jid.2008.423"},{"key":"bibr4-1203475419847955","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/91.16.1409"},{"key":"bibr5-1203475419847955","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12492"},{"key":"bibr6-1203475419847955","doi-asserted-by":"publisher","DOI":"10.1001\/archdermatol.2008.609"},{"key":"bibr9-1203475419847955","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4757-3656-4"},{"key":"bibr11-1203475419847955","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(96)90273-X"},{"key":"bibr12-1203475419847955","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2011.05.021"},{"key":"bibr13-1203475419847955","doi-asserted-by":"publisher","DOI":"10.1007\/s10865-014-9558-5"},{"key":"bibr14-1203475419847955","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2016.3156"},{"key":"bibr15-1203475419847955","doi-asserted-by":"publisher","DOI":"10.1177\/1359105310364177"},{"key":"bibr16-1203475419847955","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.26706"},{"key":"bibr18-1203475419847955","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(96)90274-1"},{"key":"bibr19-1203475419847955","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2004.04.022"},{"key":"bibr20-1203475419847955","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.5415"},{"key":"bibr21-1203475419847955","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2013.10.030"},{"key":"bibr22-1203475419847955","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2017.06.024"},{"key":"bibr23-1203475419847955","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-197011000-00017"},{"key":"bibr24-1203475419847955","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/88.1.17"},{"key":"bibr25-1203475419847955","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-09-0310"},{"key":"bibr26-1203475419847955","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19841215)54:12<3048::AID-CNCR2820541239>3.0.CO;2-M"},{"key":"bibr27-1203475419847955","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.84"},{"key":"bibr28-1203475419847955","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2014.08.014"},{"key":"bibr29-1203475419847955","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2008.03.026"},{"key":"bibr30-1203475419847955","doi-asserted-by":"publisher","DOI":"10.1177\/107327481402100411"},{"key":"bibr31-1203475419847955","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.14026"},{"key":"bibr32-1203475419847955","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.69.2855"}],"container-title":["Journal 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