1 Dermato-Venerologisk Afdeling og Videncenter for Sårheling (D/S), Bispebjerg and Frederiksberg Hospital, The Capital Region of Denmark
Socioeconomic status (SES) is associated with cutaneous malignant melanoma (CMM), also in Northern Europe despite equal access to health care. SES per se is not responsible for this association which must be ascribed to important risk factors for CMM such as intermittent UVR exposure, and screening for CMM possibly owing to a greater knowledge and understanding of CMM. Our review of the literature showed that high SES is associated with increased risk of CMM, thinner tumours, increased survival, and decreased mortality from CMM - the latter shown among women, and in recent studies also among men. There is evidence that high SES is associated with sun holidays, whereas low SES is associated with use of sunbeds. Findings suggest that high SES is associated with use of physicians and dermatologists for marks and moles, possibly due to more knowledge and better understanding of CMM. We conclude that there has been a true increase in CMM incidence among high SES individuals in Northern Europe probably due to past intense intermittent UVR exposure, especially in connection with sun holidays. However, the increased risk of CMM and a better outcome of CMM in high SES individuals may also be conditioned by frequent recourse to physicians, which may be ascribed to more knowledge and better understanding of CMM, although more studies on this subject are warranted. Thicker CMM tumours and increased CMM mortality among low SES individuals in recent decades may reflect exposure to intermittent UVR such as use of sunbeds, as well as delayed diagnosis. This article is protected by copyright. All rights reserved.
British Journal of Dermatology, 2014, Vol 170, Issue 4, p. 787-793