Disparities in Cutaneous Melanoma Diagnosis and Survival Among American Indian and Alaskan Native Patients: A Systematic Review and Meta‐Analysis

Backgrounds and Methods American Indian and Alaska Native (AI/AN) populations face significant health disparities across multiple cancer types, yet melanoma‐specific outcomes remain under‐investigated. A comprehensive search of Embase, Scopus, and PubMed identified 20 studies meeting inclusion criteria. Three meta‐analyses were conducted using random effects models to assess: (1) adjusted hazard ratios for mortality risk, (2) adjusted odds ratios for late‐stage diagnosis, and (3) age‐adjusted incidence rates. Results The meta‐analysis revealed significant disparities in melanoma outcomes for AI/AN patients. AI/AN patients demonstrated a 43% higher mortality risk compared to white patients (pooled aHR = 1.43, 95% CI: 1.12–1.82, p = 0.0041) and a 75% higher likelihood of late‐stage diagnosis (pooled adjusted OR = 1.75, 95% CI: 1.16–2.65, p = 0.0080). AI/AN patients consistently presented with worse prognostic factors including higher Breslow thickness, increased ulceration rates, and more advanced disease stages. Conclusion This study provides the first meta‐analytic evidence demonstrating statistically significant disparities in melanoma outcomes among AI/AN populations. Systemic barriers include insurance disparities, geographic isolation, treatment delays, and limited access to specialized dermatologic care. Discussion These findings justify targeted interventions including enhanced screening programs, improved healthcare infrastructure, and policy reforms to address insurance and access barriers affecting AI/AN communities.