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Treatment Delay in Melanoma: A Risk Factor Analysis of an Impending Crisis.

Risk factors associated with melanoma treatment delay (MTD) have been inadequately studied. To elucidate MTD associations based on patient and tumor characteristics, a retrospective cohort study was performed for cutaneous melanoma cases reported to the National Cancer Database (NCDB) between 2004 and 2015. We evaluated the number of days from diagnosis to treatment initiation, analyzing postponements more than 45 days as moderate MTD (mMTD) and postponements more than 90 days as severe MTD (sMTD). Greater MTD rates were independently associated with patients who are older than 50 years, female, nonwhite, not privately insured, and treated at an academic facility and who have more advanced tumor stage and head/neck primaries.