Melanoma Follow-Up and Mortality: A Large-Scale Study of Medicare Patients

The large-scale study using the SEER Medicare-linked database assessed follow-up adherence and its impact on mortality among 10,813 Medicare patients diagnosed with melanoma between 2005 and 2013. The study found that 97% of patients had at least one follow-up visit, with 80.5% having their first follow-up within 6 months and 88.6% within 12 months. Patients diagnosed by a dermatologist were more likely to follow up, and those who followed up generally lived in higher socioeconomic status communities. Mortality was significantly higher for patients who saw providers other than dermatologists at follow-up (adjusted hazard ratio [aHR] 1.88). Other factors associated with increased mortality included older age (aHR 1.09), male sex (aHR 1.76), Hispanic ethnicity (aHR 1.61), advanced melanoma stage, lower education levels, living below the poverty level, and follow-up within 12 months (aHR 1.27). The study concluded that while most patients follow up within a year, socioeconomic and provider factors significantly influence both follow-up and mortality, highlighting areas for future research and public health interventions in melanoma management.