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Greater Distance to Doctor Linked to Thicker Melanoma

Breslow thickness grows as miles to health care providers increase

MONDAY, Aug. 20 (HealthDay News) -- The thickness of a patient's melanoma is associated with the distance that a patient must travel to see the health care provider who diagnoses it, researchers report in the August issue of the Archives of Dermatology.

Karyn B. Stitzenberg, M.D., of the University of North Carolina at Chapel Hill, and colleagues analyzed distance traveled and Breslow thickness at diagnosis of 615 North Carolina melanoma patients. The investigators used data collected for the Genes, Environment, and Melanoma study.

The researchers found that each 10-mile increase in distance was associated with a 6 percent increase in Breslow thickness, although the association broke down when patients had traveled more than 120 miles to the diagnosing provider. Age at diagnosis was significantly associated with Breslow thickness, but statistically significant associations were not found between Breslow thickness and poverty, sex, urban versus rural residence, or the number of dermatologists in a given area.

"Further work is needed to characterize the determinants of distance to diagnosing provider, as well as the pathways and barriers to melanoma care," the authors conclude. "Once potential barriers are identified, interventions can be developed to minimize the effect of travel distance and other sociodemographic factors on access to melanoma care."

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