{"id":8160,"date":"2024-04-29T20:00:18","date_gmt":"2024-04-29T20:00:18","guid":{"rendered":"https:\/\/www.skincancer.org\/?p=8160"},"modified":"2025-02-06T22:59:04","modified_gmt":"2025-02-06T22:59:04","slug":"ask-the-expert-why-is-a-lack-of-diversity-in-skin-cancer-trials-a-problem","status":"publish","type":"post","link":"https:\/\/www.skincancer.org\/blog\/ask-the-expert-why-is-a-lack-of-diversity-in-skin-cancer-trials-a-problem\/","title":{"rendered":"Ask the Expert: Why Is a Lack of Diversity in Skin Cancer Trials a Problem?","gt_translate_keys":[{"key":"rendered","format":"text"}]},"content":{"rendered":"<h4><span data-contrast=\"auto\">Q: People of color are underrepresented in all areas of clinical research, but especially in skin cancer clinical trials, because the disease is more common in white individuals. Why is this an issue, and what can we learn from more diversified trials?\u00a0<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/h4>\n<p><b><span data-contrast=\"auto\">Kiyanna Williams, MD: <\/span><\/b><span data-contrast=\"auto\">We still do not know enough about <\/span><a href=\"https:\/\/www.skincancer.org\/skin-cancer-information\/skin-cancer-skin-of-color\/\"><span data-contrast=\"none\">skin cancer in patients of color<\/span><\/a><span data-contrast=\"auto\">, and this impacts our ability to diagnose it in its early, more treatable stages. Skin cancer <\/span><a href=\"https:\/\/www.skincancer.org\/blog\/are-people-of-color-at-risk-for-skin-cancer\/\"><span data-contrast=\"none\">presents differently in patients of color<\/span><\/a><span data-contrast=\"auto\"> \u2014 occurring on different locations of the body and with different clinical features. When patients of color have skin cancer, the time it takes for them to get a diagnosis is much longer than it is for their white counterparts. Since they have had the skin cancer for a longer period of time, it tends to be diagnosed at a much worse stage. With melanoma, there are many disparities.\u00a0<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">People of color are more commonly diagnosed with a form of melanoma called <\/span><a href=\"https:\/\/www.skincancer.org\/blog\/acral-melanoma-survivor-warns-know-what-to-look-for\/\"><span data-contrast=\"none\">acral lentiginous melanoma<\/span><\/a><span data-contrast=\"auto\"> (ALM), a rare, aggressive and sometimes deadly type of skin cancer that appears on the palms of the hands, the soles of the feet or under the nails. This is the type of <\/span><a href=\"https:\/\/www.skincancer.org\/blog\/bob-marley-should-not-have-died-from-melanoma\/\"><span data-contrast=\"none\">melanoma that killed singer Bob Marley<\/span><\/a><span data-contrast=\"auto\">. It often requires specialized treatment, including surgery and immunotherapy, and a multidisciplinary medical team. It takes longer for patients of color to receive treatment \u2014 even if you control for other factors like lack of insurance or proximity to a hospital. One study found that the five-year <\/span><a href=\"https:\/\/www.skincancer.org\/skin-cancer-information\/skin-cancer-skin-of-color\/\"><span data-contrast=\"none\">survival rate for Black people<\/span><\/a><span data-contrast=\"auto\"> with melanoma is only 70 percent.<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Another issue is that the risk of skin cancer in patients of color is generally lower compared to white patients, so clinical suspicion may not be as high in this patient population. This can result in a lesser tendency to <\/span><a href=\"https:\/\/www.skincancer.org\/blog\/you-need-a-biopsy-now-what-happens-part-1\/\"><span data-contrast=\"none\">biopsy a lesion<\/span><\/a><span data-contrast=\"auto\"> found on patients with darker skin. We should lower our threshold for doing biopsies on patients of color. Even if a lesion does not look like a \u201cclassic\u201d skin cancer, I will go ahead and biopsy it if the patient is telling me that a spot is changing, itching or bleeding.<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">There is also a lot of <\/span><a href=\"https:\/\/www.skincancer.org\/blog\/are-people-of-color-at-risk-for-skin-cancer\/\"><span data-contrast=\"none\">misinformation out there<\/span><\/a><span data-contrast=\"auto\"> that more diversity in research could help correct. For example, some physicians tell patients of color that they don\u2019t need sunscreen. While it\u2019s true that having more melanin in your skin provides some UV protection, it\u2019s not enough. (The darkest skin tone only provides the equivalent of SPF 13.) Everyone still needs to wear sunscreen to protect against skin cancer and other <\/span><a href=\"https:\/\/www.skincancer.org\/blog\/surprising-signs-of-sun-damage\/\"><span data-contrast=\"none\">skin problems, such as hyperpigmentation<\/span><\/a><span data-contrast=\"auto\">.\u00a0<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">We have to increase patient and provider awareness and make sure people of color know that they should be getting annual skin cancer checks. They should also learn to do <\/span><a href=\"https:\/\/www.skincancer.org\/early-detection\/self-exams\/\"><span data-contrast=\"none\">regular skin self-exams<\/span><\/a><span data-contrast=\"auto\"> to look for anything new, changing or unusual, as <\/span><a href=\"https:\/\/www.skincancer.org\/early-detection\/the-big-see\/\"><span data-contrast=\"none\">The Skin Cancer Foundation\u2019s Big See campaign<\/span><\/a><span data-contrast=\"auto\"> teaches. And find a dermatologist they like, so they can follow up.<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Across the board in dermatology, there is a massive lack of proper representation in research, and we won\u2019t have statistical significance in our calculations unless we have a larger number of diverse patients participating. Why does it take longer from diagnosis to treatment in patients of color? Why do they have a higher morbidity and mortality rate from skin cancer? We need more people of color in skin cancer research to help answer these questions and get them better care.\u00a0<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Diversity in research is important; the more we know, the better able we are to diagnose and treat skin cancer, and the better able we are to combat these disparities that are inherent in our society. <\/span><i><span data-contrast=\"auto\">\u2014 Interview by Amy Brightfield<\/span><\/i><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<hr \/>\n<p><b><span data-contrast=\"auto\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-8162 alignleft\" src=\"https:\/\/www.skincancer.org\/wp-content\/uploads\/Kiyanna-Williams-MD-Headshot-600x480.jpg\" alt=\"\" width=\"246\" height=\"197\" srcset=\"https:\/\/www.skincancer.org\/wp-content\/uploads\/Kiyanna-Williams-MD-Headshot-600x480.jpg 600w, https:\/\/www.skincancer.org\/wp-content\/uploads\/Kiyanna-Williams-MD-Headshot-1024x819.jpg 1024w, https:\/\/www.skincancer.org\/wp-content\/uploads\/Kiyanna-Williams-MD-Headshot-768x614.jpg 768w, https:\/\/www.skincancer.org\/wp-content\/uploads\/Kiyanna-Williams-MD-Headshot-1536x1229.jpg 1536w, https:\/\/www.skincancer.org\/wp-content\/uploads\/Kiyanna-Williams-MD-Headshot-2048x1638.jpg 2048w, https:\/\/www.skincancer.org\/wp-content\/uploads\/Kiyanna-Williams-MD-Headshot-scaled.jpg 1920w\" sizes=\"auto, (max-width: 246px) 100vw, 246px\" \/><\/span><\/b><\/p>\n<h5>About the Expert:<\/h5>\n<p><b><span data-contrast=\"auto\">Kiyanna Williams, MD,<\/span><\/b><i><span data-contrast=\"auto\"> is a board-certified dermatologist and Mohs surgeon in Cleveland, specializing in skin of color, surgical and cosmetic dermatology.\u00a0<\/span><\/i><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n","protected":false,"gt_translate_keys":[{"key":"rendered","format":"html"}]},"excerpt":{"rendered":"<p>The time from melanoma diagnosis to treatment is longer in patients of color than in their white counterparts. We need more diversity in clinical trials to know why these disparities exist.<\/p>\n","protected":false,"gt_translate_keys":[{"key":"rendered","format":"html"}]},"author":1,"featured_media":8161,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[5489,2880],"tags":[],"class_list":["post-8160","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ask-the-expert","category-the-skin-cancer-foundation-journal"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v25.3 (Yoast SEO v25.3) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Ask the Expert: Why Is a Lack of Diversity in Skin Cancer Trials a Problem? - The Skin Cancer Foundation<\/title>\n<meta name=\"description\" content=\"Skin cancer in skin of color is often diagnosed at later stages and has worse outcomes. 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