Insurance, Race, and Socioeconomic Disparities in Receipt of Surgical Treatment for Melanoma in the United States: A Systematic Review.

Authors

Rabecca-Kimberly Hernandez, Shoshana Zhang, Jordan Cheek, Rija Aziz, Imelda L Vetter, Alex B Haynes, Adewole S Adamson

Published in

The Journal of surgical research. Volume 325. Pages 250-260. Jun 23, 2026. Epub Jun 23, 2026.

Abstract

Disparities in surgical care for melanoma are well-documented, yet no comprehensive synthesis has examined how insurance status, race/ethnicity, and socioeconomic status (SES) affect access to surgical treatment.
We conducted a systematic review of peer-reviewed, English-language studies involving U.S. populations that assessed receipt of melanoma surgery-definitive excision and/or nodal procedures-stratified by insurance, SES, and race/ethnicity. Searches were performed in PubMed, Embase, and Web of Science through July 10, 2025. Citation searches and quality assessments followed the Oxford Center for Evidence-Based Medicine framework and Newcastle-Ottawa Scale.
Of 9770 screened records, 43 retrospective cohort studies met inclusion criteria, representing 2,957,954 melanoma patients from 1975 to 2020. Twenty-four studies examined nodal procedures; 19 focused on excision. Disparities in procedure receipt or timing were reported in 88% of nodal and 95% of excision studies. Only 39% of studies included all three sociodemographic variables. The National Cancer Database (63%) and Surveillance, Epidemiology, and End Results Program (30%) were the most commonly used datasets. Findings of disparities varied in direction and magnitude, even among studies using the same data sources.
Insurance status, race/ethnicity, and SES are frequently associated with disparities in melanoma surgery. However, inconsistent measurement and incomplete sociodemographic data limit comparability and confidence in effect estimates. Standardized definitions and rigorous analyses are needed to identify where disparities are most impactful and to guide equity-focused interventions.

PMID:
42335621
Bibliographic data and abstract were imported from PubMed on 24 Jun 2026.

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