ArticleJournal of the American Academy of Dermatology2026
Geographic variation in the impact of novel melanoma therapies on mortality.
Article in Journal of the American Academy of Dermatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
4 authors.
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Abstract
backgroundNovel immunotherapies and targeted therapies have transformed melanoma treatment, but the geographic distribution of benefits remains unclear.
objectiveTo quantify county-level variation in melanoma mortality declines following the introduction of novel therapies and identify associated patient and health system factors.
methodsWe conducted a repeated cross-sectional ecological study using county-level mortality data from the Surveillance, Epidemiology, and End Results Program. The primary outcome was percent change in age-adjusted melanoma mortality between 2008-2013 and 2019-2023. County characteristics were obtained from the Area Health Resource File, American Hospital Association Survey, Medicare claims, and National Provider Identifier database. Associations were assessed using ordinary least squares regressions.
resultsNational melanoma mortality declined 25.6% between 2008-2013 and 2019-2023. Across 751 counties, declines varied widely (median, 23.8%; interquartile range, 7.6% to 35.6%). County population size was the strongest predictor of mortality decline (β = 4.5; 95% confidence interval, 1.6-7.4; P = .002). Had all counties achieved the mortality reductions of the largest counties, 2818 additional deaths could have been prevented. LIMITATIONS: Ecological design and reliance on aggregates limit causal inference and individual-level interpretation.
conclusionsPopulation size strongly predicts mortality benefits from novel melanoma therapies, underscoring the importance of strengthening health care infrastructure to reduce geographic disparities.
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