Socioeconomic status and chemotherapy use for melanoma in older people

The study objective was to examine the association, among older persons with cutaneous melanoma, between areal socioeconomic status (SES) and receiving chemotherapy. SEER-Medicare-linked database (1,239 white men and women aged 66, with invasive melanoma [regional and distant stages]; 1991-1999) was used. SES was measured by census tract poverty level (average of 1990 and 2000 Census data). Covariates were sociodemographics, tumor characteristics, and comorbidity index. Residing in poorer SES areas was associated with a lower likelihood for receiving chemotherapy among patients in the overall sample (adjusted odds ratios = OR 0.97, 95% confidence interval = CI 0.95-0.99), and those with regional stage at diagnosis (OR 0.97, 95% CI 0.94-0.98). These findings reflect socioeconomic disparities in chemotherapy use for melanoma among older white patients in the United States.