Melanoma Research Insights: Impact, Trends, Opportunities

Melanoma research insights: impact, trends, opportunities

Analytical Services Contents

Executive summary 3

1 Global impact of melanoma 4

2 Melanoma research: progression and trends 7

3 Countries and institutions leading the charge 14

4 Research opportunities going forward 20

Melanoma research insights: impact, trends, opportunities Executive summary

The incidence of melanoma has risen rapidly over the past Key findings 50 years, and analysis of the research landscape suggests that countries and institutions worldwide are responding. Disability Adjusted Life Years Resources are being invested not only in understanding (DALYs) per 1000 individuals in the epidemiology, but also in discovering and testing novel each country therapies and improving diagnostics to facilitate earlier detection. Today, melanoma represents four to five percent 21.65 global Disability Adjusted of all cancer research globally. Immunotherapy – both Life Years rate monotherapy and combinations – is a dominant theme in 20 years life lost per 1,000 people therapeutics studies. (p. 6) The United States is leading the charge in melanoma research overall, followed by China and Germany. That Top 10 countries based on said, a substantial portion of the scholarly output from the publication count top 10 countries includes collaborations with institutions • United States • France outside the country and between academic and corporate • China • Australia researchers. The same is true at the institutional level. For example, 41% of Harvard University’s melanoma research • Germany • Japan output involves international collaborations, as does 58% of • Italy • Spain the output from Université Paris-Saclay. • UK • Canada (p. 13) Although data on disparities is sparse, organizations such as the US National Cancer Institute, among others, have shown Top 10 institutions based on that melanoma disproportionately affects men compared publication count with women, and that there is low awareness among clinicians and the general population about melanoma risks • Harvard University for people of color. These areas may represent research • University of Texas MD Anderson opportunities going forward. Cancer Center • INSERM • Memorial Sloan-Kettering Cancer Center • University of Sydney • CNRS • US National Institutes of Health • Université, Paris-Saclay • University of Pennsylvania

(p. 15)

Melanoma research insights: impact, trends, opportunities 3 Chapter 1 Global impact of melanoma 1 Global impact of melanoma

Melanoma is a type of cancer that occurs when the skin cells that produce melanin become malignant.

While everyone is at some risk of developing melanoma, The preferred method of diagnosis is excisional biopsy, people at higher risk include those with: which involves removing the entire tumor. If that can’t be done, other methods may be used. Treatment options • Family history of melanoma for melanoma vary depending on the stage,3 and range 1 • Unusual-looking moles, also called atypical nevi from excision and lymph node management for resectable • Increased numbers of common nevi melanoma to novel immunotherapies and combination (i.e., moles that are benign) regimens for later-stage unresectable and recurrent • Fair skin types melanoma (see p. 11 of this report for the top 10 papers (i.e., light skin with little or no tanning ability) related to treatment). • Light eye color This research report explores the landscape of • Intermittent intense sun exposure and long-term melanoma-related research from global burden to chronic exposure research focus and country/institutional leaders, to research gaps and opportunities. Melanoma is more common in men than women, and there are more new cases among light-skinned individuals than darker-skinned individuals.2 (see p. 21)

Sun protection behaviors aimed at preventing melanoma include:

• Using sunscreen, especially in childhood • Wearing sun-protective clothing (e.g., broad-brimmed hat) • Avoiding midday sun • Avoiding sunburn • Avoiding tanning parlors

Unless otherwise indicated, data on melanoma disease risks, prevention, and treatment comes from Elsevier’s ClinicalKey®

1. Batt M et al. (2016). Does an increased number of moles correlate to a higher risk of melanoma? Melanoma Management, Jun; 3 (2) 85-85. doi: 10.2217/mmt-2016-0001 2. Cancer Stat Facts: Melanoma of the Skin. Retrieved April 30, 2019 from https://seer.cancer.gov/statfacts/html/melan.html 3. Melanoma Treatment (PDQ) - Health Professional Version. Retrieved April 30, 2019 from https://www.cancer.gov/types/skin/ hp/melanoma-treatment-pdq#_885

Melanoma research insights: impact, trends, opportunities 5 Chapter 1 | Global Impact of Melanoma

The global incidence of melanoma has risen rapidly over population, or the burden of disease, can be thought of as a the course of the last 50 years. Its incidence is greatest measurement of the gap between current health status and among fair-skinned populations, and in regions of higher an ideal health situation where the entire population lives to latitude. Incidence is greater among older populations, but an advanced age, free of disease and disability. melanoma is also among the most common cancers found For melanoma, the global DALY rate is 21.65, meaning that in adolescent and young adult populations.4 the disease is responsible for more than 20 years of life lost The World Health Organization (WHO) quantifies the and years lived with disability worldwide per 1,000 people. burden of disease from mortality and morbidity in Disability- In 2017 alone, melanoma killed one in 1,234 individuals. Adjusted Life Years (DALYs). One DALY can be thought of as Melanoma has the greatest impact in Australia, followed by one lost year of “healthy” life. nations in northern Europe (Norway, Sweden). DALYs are Specifically, DALYs are the sum of years of life lost and lowest for nations in South America, Africa, South Asia. years lived with disability. The sum of DALYs across the

DALY

. .

figure 1 Disability Adjusted Life Years (DALYs) per 1,000 individuals in each country. Source: Global Health Melanoma is responsible for Data Exchange (http://ghdx.healthdata.org/). more than 20 years of life lost and years lived with disability worldwide per 1,000 people.

4. Ward WH, Farma JM, editors. (2017) Cutaneous Melanoma: Etiology and Therapy (Internet). Chapter 1: Epidemiology of Melanoma. Retrieved April 30, 2019 from https://www.ncbi.nlm.nih.gov/books/NBK481862/

Melanoma research insights: impact, trends, opportunities 6 Chapter 2 Melanoma research: progression and trends 2 Melanoma research: progression and trends

Since 1990, research on melanoma has risen to the point that today (through 2018), it represents about four to five percent of all cancer research performed globally, with a total of close to 50,000 publications from 2013-2018.

To understand the landscape of melanoma research, we 10000 queried Scopus, a source-neutral abstract and citation 9000 database, curated by independent subject matter experts. 8000 7000 The Scopus database includes all publication types including 6000 articles, reviews, conference papers, book chapters, editorials, 5000 and abstract reports. 4000 3000

For this report, melanoma research was identified using Number of publications 2000 the term “melanoma” and querying against publication 1000 titles, abstracts and keywords. Since publications in 0 Scopus are indexed using Elsevier’s life science thesaurus, 1960 1963 1966 1969 1972 1975 1978 1981 1984 1987 1990 1993 1996 1999 2002 2005 2008 2011 2014 2017 Year Emtree, using the search term “melanoma” retrieves a figure 2 broad set of melanoma-related publications. Since 1990, Number of publications on melanoma from 1960 to present. Source: Scopus research on melanoma has risen to the point that today (through 2018), it represents about four to five percent of all cancer research performed globally, with a total of close 6 to 50,000 publications from 2013-2018. 5

1 Percentage ofPercentage cancer research

0 1960 1963 1966 1969 1972 1975 1978 1981 1984 1987 1990 1993 1996 1999 2002 2005 2008 2011 2014 2017

Year figure 3 Melanoma related publications shown as a percentage of all cancer related publications.5 Source: Scopus

5. Cancer research defined in Scopus using query: (TITLE-ABS-KEY (cancer) OR INDEXTERMS(“neoplasm”))

Melanoma research insights: impact, trends, opportunities 8 Chapter 2 | Melanoma research: progression and trends

To gain perspective of the areas of focus within Melanoma research falls into three main categories melanoma research, we visualized the co-occurrence as shown below: of terms in melanoma-related publication titles and 1. Basic research (light blue), suggested by terms abstracts using VosViewer. like “cell” and “mouse.” 2. Epidemiology research (dark blue). 3. New therapeutics research (yellow), suggested by terms such as “immunotherapy” and “trial.”

figure 4 Main concepts represented in melanoma research from 2013-2018. Terms appearing at least 100 times in the title or abstract of research publications were visualized based on co-occurrence of terms using VOSviewer. Source: Scopus

Melanoma research insights: impact, trends, opportunities 9 Chapter 2 | Melanoma research: progression and trends

In collaboration with research partners, Elsevier has analyzed year, and subject indexed in the Scopus database.7 FWCI is citation patterns of Scopus-indexed publications to define nearly considered one of the most sophisticated indicators in the 100,000 research topics.6 Whereas ASJC categories are broader modern bibliometric toolkit. and enable us to see trends, research topics offer a more To better understand the disciplines within which melanoma granular level of insight on the focus of melanoma research. research occurs, we assessed the publications according Not all published studies have the same impact on to subject. Subjects are defined according to 27 All Science melanoma research. To determine the most influential Journal Classification (ASJC) categories. For melanoma, publications within a topic area, we use field-weighted research appears mainly in subjects such as medicine, citation impact (FWCI), which is an assessment of the biochemistry, genetics and molecular biology, pharmacology, number of citations actually received by a publication toxicology and pharmaceutics, and chemistry, with a smaller compared to the number of citations expected for a amount of research in other subjects. publication of the same document type, publication

Neuroscience Pharmacology, Toxicology, & Pharmaceutics Immunology & Microbiology

Biochemistry, Genetics & Molecular Biology Agricultural & Biological Sciences

Medicine Health Professions Nursing

Subject Mathematics Computer Science Physics and Astronomy Chemistry Chemical Engineering Materials Science Engineering

0 5000 10000 15000 20000 25000 30000 35000 40000

Number of Publications figure 5 Publication count distributed across ASJC subject categories. Only subjects with 400 or more publications are shown here. Source: Scopus

6. Klavans, R and Boyack, K. Research Portfolio Analysis and Topic Prominence, Journal of Informetrics. (2017) v11, p1158-1174. 7. Purkayastha, A, Palmaro, E, Falk-Krzesinski, H, Baas, J. Comparison of two article-level, field-independent citation metrics: Field-Weighted Citation Impact (FWCI) and Relative Citation Ratio (RCR) (2019) Journal of Informetrics, 13 (2), pp. 635-642.

Melanoma research insights: impact, trends, opportunities 10 Chapter 2 | Melanoma research: progression and trends

Putting it all together, we identified the 10 topics with the most publications in melanoma research from 2013-2018. The data includes topic name, number of publications, prominence score (an indicator of the momentum in a particular field), as well as the number of views received and the average FWCI. These topics run the gamut from disease pathway (e.g., MAPK) to diagnosis (e.g., biopsy) to treatment (e.g., immunotherapy, brachytherapy) to risk/prevention (e.g., tanning bed).

Percent of melanoma Prominence Topic name Publications publications score Views count Average FWCI

Immunotherapy, melanoma, immune-related adverse 2446 4.9% 99.991 97,653 4.43

Melanoma, proto-oncogene proteins b-raf, mapk pathway 2440 4.9% 99.716 38,255 1.86

Melanoma, sentinel lymph node biopsy, mitotic rate 1034 2.1% 96.962 7768 1.19

Melanoma, uveal neoplasms, melanoma, uveal melanoma 780 1.6% 96.786 7082 1.25

Dermoscopy, melanoma, dermoscopic patterns 557 1.1% 91.317 6869 1.06

Skin, dermatology, dermoscopy images 546 1.1% 93.974 11,180 1.49

Melanoma, skin neoplasms, melanoma mortality 519 1.0% 92.278 6078 1.25

Solar system, tanning, tanning bed 441 0.9% 97.243 17,809 1.07

Melanoma, brachytherapy, radiation retinopathy 423 0.9% 89.133 4086 0.77

Monophenol monooxygenase, melanins, tyrosinase inhibitor 417 0.8% 97.557 22,533 0.94 figure 6 Top 10 topics represented in melanoma research (based on publication count).* Topics are ascribed names based on the three most common key phrases found in research titles and abstracts for that topic. Key phrases are generated by matching against a set of thesauri spanning all major disciplines, thus reducing the occurrence of redundant terms (e.g., neoplasm and cancer).

*Data is available for the top 50 results in this area. Contact Elsevier if you are interested in learning more.

Melanoma research insights: impact, trends, opportunities 11 Chapter 2 | Melanoma research: progression and trends

As shown by the analysis of topics represented in melanoma research, immunotherapy represents a highly researched topic within melanoma research. Immunotherapy related research also has a very high academic impact. When assessing the top publications from 2013-2018 based on FWCI, we found that among the top 50, publications related to immunotherapies stand out as a dominant theme. The top 10 immunotherapy papers include both monotherapy and combinations. These publications have an FWCI ranging from 180 up to 450, indicating a citation accrual much higher than publications of a similar age and type.

Rank Title

1 Larkin J et al. (2015). Combined nivolumab and ipilimumab or monotherapy in untreated melanoma. New Engl J Med, 373 (1) 23-34. doi: 10.1056/NEJMoa1504030

2 Robert C et al. (2015). Nivolumab in previously untreated melanoma without BRAF mutation. N Engl J Med, 372 (4) 320-330. doi: 10.1056/NEJMoa1412082

3 Robert C et al. (2015) Pembrolizumab versus ipilimumab in advanced melanoma. N Engl J Med, 372 (26) 3531-2532. doi: 10.1056/NEJMoa1503093

4 Wolchok J et al. (2013). Nivolumab plus Ipilimumab in advanced melanoma. N Engl J Med, 369 (2) 122-133. doi: 10.1056/NEJMoa1302369

5 Postow M et al. (2018). Immune-related adverse events associated with immune checkpoint blockade. N Engl J Med, 378 (2) 158-168. doi: 10.1056/NEJMra1703481

6 Hamid O et al. (2013) Safety and tumor responses with lambrolizumab (anti-PD-1) in melanoma. N Engl J Med, 369 (2) 134-144. doi: 10.1056/NEJMoa1305133

7 Postow M et al. (2017). Nivolumab and ipilimumab versus ipilimumab in untreated melanoma. N Engl J Med, 372 (21) 2006-2017. doi: 10.1056/NEJMoa1414428

8 Snyder A et al. (2014). Genetic basis for clinical response to CTLA-4 blockade in melanoma. N Engl J Med, 371 (23) 2189-2199. doi: 10.1056/NEJMoa1406498

9 Wolchok J et al. (2017). Overall survival with combined Nivolumab and Ipilimumab in advanced melanoma. N Engl J Med, 377 (14) 1345-1356 doi: 10.1056/NEJMoa1709684

10 Robert C. (2015) Improved overall survival in melanoma with combined dabrafenib and trametinib. N Engl J Med, 372 (1) 30-39. doi: 10.1056/NEJMoa1412690 figure 7 The top 10 immunotherapy papers based on FWCI among melanoma related publications include both monotherapy and combinations.*

*Data is available for the top 50 results in this area. Contact Elsevier if you are interested in learning more.

Melanoma research insights: impact, trends, opportunities 12 Chapter 2 | Melanoma research: progression and trends

While most melanoma research is taking place in medicine, the field of computer science is also making an impact based on FWCI, particularly in melanoma diagnostics. These high impact melanoma publications, shown in the following table, have an FWCI ranging from 10 to 30.

Rank Title

1 Dey N et al. (2018). Social group optimization supported segmentation and evaluation of skin melanoma images. Symmetry 10 (2) 51. doi: 10.3390/sym10020051

2 Mendonca T et al. (2013). PH2 - A dermoscopic image database for research and benchmarking. Conf Proc IEEE Eng Med Biol Soc, 6610779. doi: 10.1109/EMBC.2013.6610779

3 Wang C et al. (2017). In situ activation of platelets with checkpoint inhibitors for post-surgical cancer immunotherapy. Nat Biomed Eng, 1 (2) 11. doi: 10.1038/s41551-016-0011

4 Yu L et al. (2017). Automated Melanoma Recognition in Dermoscopy Images via Very Deep Residual Networks. IEEE Trans Med Imaging, 36 (4) 7792699: 994-1004. doi: 10.1109/TMI.2016.2642839 Li L et al. (2017). Single-impulse panoramic photoacoustic computed tomography of small-animal 5 whole-body dynamics at high spatiotemporal resolution. Nat Biomed Eng, 1 (5) 71. doi: 10.1038/s41551-017-0071

6 Codella N et al. (2015). Deep learning, sparse coding, and SVM for melanoma recognition in dermoscopy images. Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics), 9352: 118-126. doi: 10.1007/978-3-319-24888-2_15

7 Codella N et al. (2017). Deep learning ensembles for melanoma recognition in dermoscopy images. IBM J Res Dev, 61 (4): 8030303. doi: 10.1147/JRD.2017.2708299

8 Lin BS et al. (2018). Skin lesion segmentation: U-Nets versus clustering. 2017 IEEE Symposium Series on Computational Intelligence, SSCI 2017 – Proceedings, January 2018: 1-7. doi: 10.1109/SSCI.2017.8280804

9 Jain S et al. (2015). Computer aided Melanoma skin cancer detection using Image Processing. Procedia Comput Sci, 48: 736-741. doi: 10.1016/j.procs.2015.04.209

10 Majtner T et al. (2017) Combining deep learning and hand-crafted features for skin lesion classification. 2016 6th International Conference on Image Processing Theory, Tools and Applications, IPTA 2016, 6610779: 5437-5440. doi: 10.1109/EMBC.2013.6610779 figure 8 Impact of melanoma research in the discipline of computer science, ranked based on FWCI.*

*Data is available for the top 50 results in this area. Contact Elsevier if you are interested in learning more.

Melanoma research insights: impact, trends, opportunities 13 Chapter 3 Countries and institutions leading the charge 3 Countries and instutions leading the charge

The United States is the top producer of melanoma research, followed by China, Germany, Italy and the UK.

It is possible to understand which countries are lead contributors in melanoma research by assessing publication output. This analysis reveals that the United States, which has published over 17,000 publications on melanoma, surpasses the next second highest contributor, China, by over 13,000 publications.

Scholarly Output

figure 9 Scholarly output in melanoma research per country among nations publishing at least 50 publications from 2013-2018. Source: Scopus

Melanoma research insights: impact, trends, opportunities 15 Chapter 3 | Countries and institutions leading the charge

Our data for the top 10 countries includes publication count, outputs in top citation percentiles, percentage of international collaborations, FWCI, and percentage of academic-corporate collaborations.

The table shows that countries with higher levels of collaboration tend to have higher outputs and higher FWCIs.

Scholarly output/ Outputs in top citation Field-weighted Academic-corporate Country publication count percentiles (%) Collaboration (%) citation impact collaboration (%)

United States 17835 29.7 31.4 2.62 5.3

China 4711 22.9 28.8 1.47 1.2

Germany 3814 28.9 50.4 2.87 7.7

Italy 3686 26.3 42.5 2.56 4

United Kingdom 3408 31.2 56.2 3.17 8.1

France 2890 30.7 49.3 4.13 8.3

Australia 2545 31.9 49.4 3.84 7.1

Japan 2436 20.2 27 1.89 4

Spain 1890 23.4 47.6 3.1 5.9

Canada 1586 30.6 57.1 4.22 9.7

figure 10 Top 10 countries based on publication count (melanoma, 2013-2018).*

*Data is available for the top 50 results in this area. Contact Elsevier if you are interested in learning more.

Melanoma research insights: impact, trends, opportunities 16 Chapter 3 | Countries and institutions leading the charge

To provide insight on the relative level of focus on melanoma proportion seen, on average, globally. When a country’s RAI is research in each country, we used a metric called the Relative below 1.0, its research is below the proportion seen globally. Activity Index (RAI). RAI is a measure of the proportion of Here, using data from 2013-2018, we look at the relative the country’s research output in the subject (i.e., melanoma) activity in melanoma research in countries worldwide that relative to the proportion seen globally. produced at least 1,000 publications during the period. When a country’s RAI for a particular subject is above 1.0, it indicates that the country’s research in this subject exceeds the

Italy United States Australia

Switzerland France Netherlands Germany Spain

Country Japan United Kingdom South Korea Brazil Canada China India

0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 2.0

RAI figure 11 Relative activity in melanoma research in each country for countries with 1,000 or more publications during the period 2013-2018. We find that the Relative Source: Scopus Activity Index is highest in Italy and the United States, followed by Australia, Switzerland and France.

Melanoma research insights: impact, trends, opportunities 17 Chapter 3 | Countries and institutions leading the charge

On the institutional level, much of the output from the top 10 institutions, based on publication count, represents international collaborations, with a high of 57.8% from Expanding Université Paris-Saclay. Academic-corporate collaborations research impact8 are also prominent, with a high of 16.8% for the University of California at Los Angeles. While the impact of scholarly publications on melanoma research is calculated within the context of global Outputs in Field- Academic- scientific publications that are read and top citation International- weighted corporate Scholarly percentiles collaboration citation collaboration cited mainly by researchers, clinicians, Institution output (%) (%) impact (%) academics and other medical/scientific professionals, some of these publications Harvard University 1830 41.6 41.3 4.18 9 gain wider impact via publication on

University of Texas internet sites that reach the public. MD Anderson 1187 38.9 35.6 4.09 9.5 Using PlumX metrics, it is possible to Cancer Center understand the ways that academic INSERM 1168 35.4 44.6 3.67 6.2 research informs broader audiences.

Memorial For example, Medline Plus, the US Sloan-Kettering 1087 44.9 41.7 6.04 10.6 Cancer Center National Library of Medicine’s site, provides health and medical information University of Sydney 806 38.5 49.6 6.78 8.3 aimed mainly at patients and families, although health professionals access CNRS 796 33.4 53.6 2.44 7.7 the site as well. Medline Plus has cited 289 relevant publications in US National the melanoma guidelines it makes Institutes of 791 44.2 44.4 3.77 10.9 Health accessible to the public.

Université Similarly, melanoma guidelines from Paris-Saclay 675 41.9 57.8 5.85 13.9 NICE (National Institute for Health and Care Excellence), which are University of 633 41.9 34.3 4.44 11.4 Pennsylvania evidence-based recommendations University of for health and care in England, cite California at 583 43.6 46.1 7.42 16.8 Los Angeles 38 melanoma publications. figure 12 Top 10 institutions based on publication count (melanoma, 2013-2018).*

*Data is available for the top 50 results in this area. Contact Elsevier if you are interested in learning more.

8. Source: PlumX Metrics

Melanoma research insights: impact, trends, opportunities 18 Chapter 3 | Countries and institutions leading the charge

Assessing the top 24 institutions engaged in cross- institutional collaborations on melanoma research reveals the important role of cancer centers and hospitals in facilitating research and collaboration. These highly collaborative institutions are connected with many other institutions and these connections are the result of many collaborations (indicated by the thickness of the lines).

figure 13 Top institutions engaged in cross-institutional collaboration.

Melanoma research insights: impact, trends, opportunities 19 Chapter 4 Research opportunities going forward 4 Research opportunities going forward

This report focuses on impact and trends in melanoma research today. We also uncovered two areas that would benefit from additional research: gender disparities and ethnic/racial disparities.

To understand the frequency with which a sex or gender In the US, about 96,480 new melanomas dimension is incorporated into research design, we assessed will be diagnosed how often men and women were both referred to in publication abstracts. This proxy for assessing sex or gender 57,220 men dimension in research content (SGDRC) revealed that among the close to 50,000 melanoma publications from 2013-2018, a total of 12,482 include SGDRC (measured as reference to 39,260 women both sexes, sex or gender differences, sexual dimorphism); 4,131 mention men or males only and 5,631 mention women or females only in the abstract. About 7,230 people It is difficult to draw conclusions based on these small are expected to die of melanoma numbers. However, it is likely that more research is needed to understand the biological bases of the gender differences 4,740 men in incidence and prevalence that affect men, and to foster awareness among men about prevention.

The difference in incidence by sex is exemplified in the 2,390 women United States. The American Cancer Society’s estimates for melanoma in for 2019 are:10 The American Academy of Dermatology also highlights men’s higher risk of melanoma and suggests that part of the reason melanoma strikes men harder is that men know less about skin cancer. This was reflected in a survey by the academy conducted in 2016.11

9. Cancer Stat Facts: Melanoma of the Skin. Retrieved April 30, 2019 from https://seer.cancer.gov/statfacts/html/melan.html 10. American Cancer Society: Key Statistics for Melanoma Skin Cancer. Retrieved April 30, 2019 from https://www.cancer.org/cancer/ melanoma-skin-cancer/about/key-statistics.html 11. American Academy of Dermatology: Survey: Men’s skin cancer knowledge lags behind women’s. Retrieved April 30, 2019 from https://www.cancer.org/cancer/melanoma-skin-cancer/about/key-statistics.html

Melanoma research insights: impact, trends, opportunities 21 Chapter 4 | Research opportunities going forward

A similar gap is reflected in knowledge and treatment of skin cancer, including melanoma, in people of color. Studies done in the US show that although dark-skinned individuals are less likely than light-skinned individuals to get melanoma, those who do face a five-year survival rate, ranging from 72% for African Americans to 81% for Hispanics – compared to close to 90% for Caucasians.12

Researchers have identified ethnic/racial gaps, including the lack of clear definition of people of color in the literature; false assumptions among dermatologists that people of color don’t go to tanning salons and are therefore not at risk for UV-induced skin cancer; and false beliefs among people of color that dark pigmentation totally protects against skin cancer.13 Research in this area might prompt collaborations among stakeholders to initiate skin cancer prevention programs for these populations.

In the US, the five-year survival rate differs by population, ranging from 72% for African Americans to 81% for Hispanics – compared to close to 90% for Caucasians.

12. Kailas A et al. (2016). Gaps in the understanding and treatment of skin cancer in people of color. Journal of the American Academy of Dermatology. Retrieved April 30 from https://www.jaad.org/article/S0190-9622(15)02502-5/pdf 13. Ibid.

Melanoma research insights: impact, trends, opportunities 22 About

Elsevier is a global information analytics business that helps scientists and clinicians find new answers, reshape human knowledge, and tackle urgent human crises. For 140 years, we have partnered with the research world to curate and verify scientific knowledge.

Today Elsevier is committed to bringing that rigor to a new generation of platforms. Elsevier provides digital solutions and tools in the areas of strategic research management, R&D performance, clinical decision support, and professional education; including ScienceDirect, Scopus, SciVal, ClinicalKey and Sherpath.

This report was prepared and published under the lead of Elsevier’s Analytical Services, part of Elsevier’s Research Intelligence portfolio of products and services.

Our Analytical Services team is experienced in serving policy makers, funders, and academic and corporate research institutions around the world. Our offerings range from simple, targeted reports to comprehensive multidimensional studies, as well as data delivery and web integration services to meet your research management needs.

Elsevier is part of RELX Group, a global provider of information and analytics for professionals and business customers across industries.

For more information about Analytical Services, please visit: elsevier.com/research-intelligence/analytical-services

Melanoma research insights: impact, trends, opportunities 23 Elsevier is a registered trademark of Elsevier B.V. | RELX Group and the RE symbol are trademarks of RELX Intellectual Properties SA, used under license. © 2019 Elsevier B.V.

Analytical Services