Melanoma is the most lethal of the common skin cancers, and its incidence continues to rise in the United States. Access to dermatologic specialty care remains below recommended benchmarks, particularly in rural and nonmetropolitan regions. This descriptive, population-based analysis examined melanoma incidence and dermatologist availability across five selected counties in southwest Missouri, with limited county-level mortality reporting. Age-adjusted melanoma incidence data were obtained from the State Cancer Profiles database (National Cancer Institute and Centers for Disease Control and Prevention) and standardized to the 2000 U.S. population. Dermatologist availability was calculated using National Provider Identifier data and reported as dermatologists per 100,000 population. Nonmetropolitan counties demonstrated comparable or higher melanoma incidence rates alongside substantially lower dermatologist density; however, findings are descriptive and do not establish causal relationships. Melanoma mortality could not be meaningfully compared across counties, as data were suppressed in multiple counties due to low case counts. Greene County, designated as the urban reference county, had the highest dermatologist density and was the only county with non-suppressed mortality data. These findings highlight geographic variation in melanoma incidence and provider distribution while underscoring the challenges of interpreting melanoma burden in sparsely populated regions.
Ladas et al. (Tue,) studied this question.