(194) Facial Cutaneous Melanoma in LA County: Three Decades of Insight

Introduction: Facial cutaneous melanoma (FCM) is a common head and neck cancer whose management has evolved over the past several decades. Few studies examine temporal changes in presentation and outcomes among FCM patients. The current study elucidated county-specific trends and modeled factors associated with increased stage at presentation.

Methods: Retrospective analysis of 1988-2018 Los Angeles Surveillance, Epidemiology, and End Results database. Demographic, clinical, and treatment data were collected. Multivariate logistic regression was used to examine factors associated with increased stage at presentation.

Results: Our 7256-patient cohort was largely white (87.62%), male (72.25%), married (65.26%), urban living (96.22%), and were on average 67.24 years old at diagnosis. From 1988 to 2018, annual reported FM cases increased from 153 to 287, with Hispanic patients experiencing a 65.85% increase in incidence rate over that time. Average diagnosis age increased by 9.94 years over this period. Average presenting tumor size decreased by 48.15mm. Notably, immunotherapy use rates increased 452.63% over this period. After adjusting for sex, age at diagnosis, and insurance type in a multivariate logistic regression, African American (p=0.043), Hispanic (p=0.031), and Asian (p=0.041) patients were significantly more likely to present at a more advanced stage relative to white patients.

Conclusions: FCM has increased in incidence over time, but with concurrent decreases in tumor size and increasing age at presentation. Although traditionally affecting white patients, changes in incidence rate and disparities in presentation among minorities suggest a need to increase screening and awareness among traditionally non-target populations.