Melanoma in the Asian American and Pacific Islander (AAPI) Community

Melanoma does not discriminate - it can impact anyone at any stage of life regardless of their race or ethnicity. That is why it is so important to regularly check your skin and see a dermatologist to evaluate any potential changes to your skin. Melanoma research has made great strides in providing effective treatments for patients, but the racial demographics of patients represented in surveys and studies do not reflect the true diversity of those impacted by melanoma. While approximately 36% of the US population is non-white (or identify as Hispanic, Black/African American, or Asian), less than 5% of patients who participate in melanoma clinical trials are non-white. "For example, in the BRIM-3 (NCT01006980) clinical trial, which led to the approval of the BRAF inhibitor vemurafenib, 671 out of 672 (99.9%) patients were of white race, and in the CheckMate067 (NCT01844505) clinical trial, which led to the approval of the combination of the immunotherapies nivolumab plus ipilimumab, 921 out of 945 (97.5%) patients were of white race," wrote the authors of the study Un-Fair Skin: racial disparities in acral melanoma research.‍

‍Asian American and Pacific Islander (AAPI) patients are especially underrepresented in melanoma research and may be overlooked when it comes to timely care and treatment for this cancer, leading to gaps in treatment and diagnoses.

Health Disparities in AAPI People with Melanoma

Despite having improved health outcomes compared to other racial/ethnic minorities, AAPI people are dying at a higher rate from cancer, including skin cancers like melanoma.

• For AAPI people, the incidence of melanoma is 1.3 in 100,000, but they have a 27% higher mortality rate compared to non-Hispanic White melanoma patients. The most common sites for melanoma development in AAPI people are the palms of the hands, soles of the feet, underneath nails - known as acral melanoma - and the lower leg/hip area of the body.  

In general, AAPI people have lower screening rates for all cancer compared to other races and ethnicities, including melanoma.  

• AAPI people are less likely to receive annual skin examinations and use sunscreen compared to non-Hispanic White people. However, AAPI people are more likely to engage in cultural practices like wearing sun-protective clothing and regularly seeking shade.

Additionally, for AAPI patients with melanoma, the disease is often diagnosed at advanced stages when melanoma is more challenging to treat.  

• Among ethnic subgroups followed in a 2023 study, South Asian melanoma patients experienced the longest period between diagnosis and surgery/treatment compared to other subgroups, with a mean delay period of nearly 51 days.  

• They, along with Southeast Asians, were more likely to present with melanoma younger and at a later stage and were more likely to be uninsured or on public health insurance like Medicaid.

Combined with socioeconomic disparities such as lower median incomes and less health insurance coverage among certain ethnic subgroups, these all compound to lead to more cases and ultimately, more lives lost to melanoma.

• Cultural perceptions and stigmas play a key role in influencing care seeking behaviors in AAPI patients—so much so that it impacts the efficacy of Western biomedical interventions in this population, especially among older immigrants.  

Resources for AAPI Patients with Melanoma

Expanding resources for AAPI patients with melanoma and increasing their representation in melanoma research and clinical trials are important steps towards addressing these longstanding gaps in timely diagnosis and access to care. Strengthening these efforts will help ensure that all melanoma patients benefit from advances in treatment and improved health outcomes.

Below is a list of current resources tailored for AAPI patients with melanoma. Be sure to ask your doctor about more resources that may be available in your area.

• Asian American Cancer Support Network: A community resource for Asian Americans who are affected by cancer, primarily serving in the Bay Area in CA to advocate for underserved communities in the local area. The AACSN hosts fundraising events year-round and sponsors community mobile clinics to promote cancer screening among AAPI people.

• Asian Health and Service Center’s Cancer Resource and Support Services: Oregon’s first culturally and linguistically specific cancer resource for Asian Americans facing cancer and their caregivers. They provide support by helping patients navigate cancer treatment and diagnosis, providing individual case management and counselling, and hosting local health education workshops.

• The American Cancer Society recently published a report on cancer statistics among AAPI people in the United States from 2021 to 2023, including updated prevalence rates for melanoma.  

At MRA, we are committed to promoting early detection and prevention among all people. Our advice remains the same: protect your skin using sunscreen and UPF clothing, check your skin for changes and signs of melanoma, and call your doctor as soon as you notice any skin concerns.