Insurance, race, and socioeconomic disparities in systemic therapy receipt for melanoma in the United States: a systematic review
Year: 2026
Type: review
Study design: Systematic Review
Abstract: BACKGROUND: Although evidence suggests disparities in melanoma treatment, no comprehensive summary exists on whether insurance type, race/ethnicity, or socioeconomic status consistently influence systemic therapy receipt. Understanding these associations may inform strategies to reduce inequities. METHODS: We conducted a systematic review of United States (US) based studies assessing systemic therapy receipt by insurance, socioeconomic status, and race/ethnicity. Searches of PubMed, Embase, and Web of Science were performed through July 10, 2025. Evidence quality was evaluated using the Oxford Center for Evidence-Based Medicine. RESULTS: Of 6,604 records screened and 223 full-texts reviewed, 30 retrospective cohort studies were included, encompassing 1,212,437 melanoma patients (1975-2021). Twenty-five studies stratified by insurance, 24 by socioeconomic status, and 21 by race/ethnicity. Insurance-based disparities were reported in 88% of studies, socioeconomic status-based disparities were reported in 75% of studies, and race/ethnicity- based disparities were reported in 38% of studies. Although 67% of studies used the National Cancer Database, findings were inconsistent across studies. CONCLUSION: Insurance and socioeconomic status may be more consistent drivers of disparities in systemic therapy receipt for melanoma than race/ethnicity. However, variability in identifying disparities, even among studies using the same database, may complicate targeted interventions.
Source: Melanoma Management
Institution: Dell Children's Medical Center of Central Texas
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,415
Award: G9000148371
OpenAlex ID: W7130324787