skin cancer at more advanced stages, says Dr. Janiene Luke, with the Skin of Color Society, a nonprofit that works to educate doctors and the public on skin health.
The five-year melanoma survival rate among non-Hispanic Black people is 66%, compared with 90% for non-Hispanic white people, according to a report by the Centers for Disease Control and Prevention. And 1 in 3 Black men or women diagnosed with melanoma in the U.S. die of the disease, compared with at least 1 in 7 for non-Hispanic white people, according to the American Cancer Society.
Given the known disparities in outcomes, Dr. Valerie Harvey, president of the Skin of Color Society, says two areas of research are needed: studying educational initiatives to see if awareness might lead to earlier diagnosis and improved survival; and determining risk factors in patients with dark skin, especially factors leading to the occurrence of melanoma in places less exposed to the sun.
Improving cultural competency and diversity within dermatology is just one step toward improving diagnosis and outcomes. According to the most recent data, fewer than 3% of dermatologists nationwide are Black. Orthopedics is the only medical specialty with a smaller share.
Dermatology has traditionally been one of the most competitive specialties in medicine, says Dr. Michelle Henry, a clinical instructor of dermatology at Weill Cornell Medicine. In addition to stiff academic requirements, admission to dermatology programs also depends on connecting with mentors and extensive networking, which can be expensive. And that, Henry said, has traditionally created barriers for Black medical students who want to pursue dermatology.
“There are so many hurdles that make it difficult for a lot of students of color to do the things that they need to do in such an uber-exclusive and small space,” she adds.
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Overcoming the barriers
Recent initiatives to help students overcome those barriers are beginning to work, says Dr. Susan Taylor, vice chair for diversity, equity, and inclusion in the dermatology department at the University of Pennsylvania and founder of the Skin of Color Society. Initiatives from the American Academy of Dermatology include holistic reviews of residency applications, mentorships, and programs to increase interest among and prepare high school students for college and medical school.
Medical app company VisualDX is working to reduce disparities in medicine through Project Impact by creating a catalog of images reflecting various diseases in different skin colors. Skin cancers may appear differently on