Comparison of melanoma incidence in metropolitan areas versus nonmetropolitan areas in the state of Texas stratified by poverty classification.

Numerous risk factors for the development of melanoma have been identified; however, there is conflicting research on whether residence in nonmetropolitan areas, with a population <49,999 people, is associated with an increased cancer risk. This retrospective study aimed to identify the correlation of nonmetropolitan residence in Texas and the incidence of melanoma, while also stratifying the results by poverty level. Data were obtained from the Texas Department of State Health Services' Texas Cancer Registry. The incidence of melanoma in Texas from 1996 to 2015 in nonmetropolitan and metropolitan counties was calculated and stratified by poverty classification. Overall, the incidence of melanoma was 51,431 out of 22,140,398 (0.23%) in metropolitan areas and 9685 out of 3,005,163 (0.32%) in nonmetropolitan areas. Thus, the proportion of residents with melanoma in nonmetropolitan areas was 1.39 times that in metropolitan areas, which translates to an ∼39% increase in likelihood to develop melanoma. When these data were stratified by poverty, 57% of the cases of melanoma among those living in nonmetropolitan counties were in areas with a poverty rate of 10% to <20%; conversely, only 2% of the cases were among those living in nonmetropolitan counties with a poverty rate of 0% to 5%.