June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Influence of Census Tract Poverty Indicator on Survival in Cases of Conjunctival and Uveal Melanoma diagnosed within the State of Texas
Author Affiliations & Notes
  • Jenson Erapuram
    Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, United States
  • Zain S Hussain
    University of Medicine & Health Sciences, Basseterre, Saint Kitts and Nevis
  • Fatma Dihowm
    Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, United States
  • Footnotes
    Commercial Relationships   Jenson Erapuram None; Zain Hussain None; Fatma Dihowm None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 3366 – A0153. doi:
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      Jenson Erapuram, Zain S Hussain, Fatma Dihowm; Influence of Census Tract Poverty Indicator on Survival in Cases of Conjunctival and Uveal Melanoma diagnosed within the State of Texas. Invest. Ophthalmol. Vis. Sci. 2022;63(7):3366 – A0153.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : In 2019, the CDC released the National Health Statistics Report highlighting the ultimate impact of poverty on healthcare utilization. Additionally, prior studies have highlighted differential incidences of melanoma stratified by poverty classification within Texas. This retrospective cohort analysis is the first of its kind in characterizing novel survival trends within the class of orbital melanomas in the state of Texas.

Methods : The Texas Cancer Registry (TCR) acted as provision for state-level standardized cancer statistics. 2,585 cases of conjunctival and uveal melanomas diagnosed between January 1, 1995 and December 31, 2018, a 23-year time interval, were extracted. All cases with unknown or arbitrary values of cause of death were eliminated from analysis. Cox proportional hazards modeling was performed to yield hazard ratios (HR) with 95% Confidence Intervals (CI). Kaplan-Meier (KM) curves were curated to visualize survival trends. Statistical significance was achieved at p<0.05. All statistical analyses were performed with IBM SPSS Version 26.

Results : N=1966 (79.1%), N=403 (16.2%), and N=116 (4.7%) cases were diagnosed with choroidal, ciliary body, and conjunctival melanomas, respectively. N=606 (24.4%) cases died of cancer-related causes and N=510 (20.5%) cases died due to causes unrelated to cancer. Patients residing in neighborhoods with poverty indices of 10-19.9% and 20-100% demonstrated 24.7%, 43.6%, and 33.0% increased hazards of multi-variable cause-specific, other-cause, and all-cause death, respectively, as compared to patients residing in neighborhoods with poverty indices of 0-5% and 5-9.9%. Within patients residing in poverty indices of 10-19.9% and 20-100%, female patients experienced increased hazards of other-cause death and former tobacco users experienced decreased hazards of cause-specific death as compared to current users (HR=0.619, p=0.019).

Conclusions : To the authors’ knowledge, this investigation is the first to characterize the influence of psychosocial parameters, including poverty, gender, and tobacco use on survival in patients diagnosed with conjunctival, choroidal, and ciliary body melanomas within the state of Texas. Reconciliation of poverty and subsequent lack of healthcare utilization and psychological well-being are likely important thought processes when delivering care to those afflicted by ophthalmic cancers.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

 

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