Background and Objectives: Melanoma is one of the fastest‐growing cancers in the United States, with nearly 100% 5‐year survival for early‐stage disease compared to 35% for late‐stage disease. Regional studies suggest that areas with increased early‐stage melanoma diagnoses may not experience a reduction in late‐stage cases, raising questions about the effectiveness of early detection. We hypothesize that higher socioeconomic status (SES) will correlate with increased early‐stage melanoma without a decrease in late‐stage disease, with geographic variation across US regions.Methods: This cross‐sectional study used SEER data to analyze 829 391 non‐Hispanic White patients diagnosed with melanoma between 2004 and 2021, including 725 077 with early‐stage (in situ/localized) and 104 314 with late‐stage (regional/distant) disease. Regression models evaluated associations between county‐level stage‐specific melanoma incidence and population characteristics, including SES, ultraviolet exposure, agricultural employment, and rural‐urban status.Results: Higher SES counties had higher early‐stage melanoma incidence without a reduction in late‐stage incidence. Counties in the West and South had increased odds of early‐stage melanoma, while rural counties exhibited lower melanoma incidence across stages. Agricultural employment and ultraviolet exposure were not consistently associated with melanoma incidence.Conclusion: Findings suggest early‐ and late‐stage melanoma may represent distinct diseases. Screening may aid in early detection, but its impact on reducing late‐stage disease and mortality remains uncertain.

Objective: To quantify the extent of the disruption and recovery of lung cancer detection during the first two years of the pandemic, focusing on disparities across demographic and community factors. Methods: This retrospective cohort study used the SEER database to identify lung cancer cases from 2001 to 2021. Expected incidence rates for 2020 and 2021 were projected based on pre-pandemic trends (2000–2019) using the NCI’s Joinpoint Regression program. Percent differences between expected and observed incidence rates were calculated. Multivariate and propensity score analyses were conducted to quantify changes in the odds of being diagnosed with metastatic disease during the pandemic. Results: Lung cancer incidence fell by 10% in 2020 compared to pre-pandemic projections, with rural populations, non-Hispanic Black and Asian patients, and females disproportionately affected. By 2021, detection rates partially recovered but remained 5% below expected levels. Localized disease detection improved significantly, while rural communities not adjacent to metropolitan areas faced further declines. Adjusted analyses showed that patients with small-cell lung cancer (SCLC) and those of Hispanic, non-Hispanic Black, or Asian/Pacific Islander ethnicity had persistently higher rates of distant disease presentation through 2021. Conclusions: The pandemic significantly reduced lung cancer detection, with only partial recovery by 2021. Persistent gaps, particularly in rural and minoritized populations, highlight the need for targeted interventions to reengage these communities.

Objectives: Immune checkpoint inhibitors demonstrate meaningful promise in advanced unresectable Merkel cell carcinoma (MCC), but their role in the adjuvant setting is evolving. We assessed the association between adjuvant immunotherapy (IO), radiation therapy (RT), or their combination and overall survival (OS) in a real-world cohort. Methods: Using the National Cancer Database (NCDB), we identified 2538 stage III MCC patients diagnosed between 2017 and 2022 with known adjuvant IO and RT status. Patients were stratified into clinically (n=720) and occult node-positive (n=1818) subgroups. Multivariable logistic regression identified predictors of receipt of adjuvant therapy, while Cox proportional hazards models assessed factors associated with OS. Results: Overall, 25% of patients received neither adjuvant IO nor RT, 6% received both therapies, 5% received IO alone, and 66% received RT alone. Adjuvant IO utilization increased from 4.3% to 13.1% of patients between 2017 and 2022. Receipt of combined IO and RT, as well as RT alone, was associated with improved OS in clinically and occult node-positive patients. Treatment at high-volume centers was associated with improved OS in occult node-positive patients. Conclusions: In this retrospective cohort, adjuvant IO combined with RT showed the strongest association with improved survival. This OS benefit was particularly pronounced in clinically node-positive patients. These real-world findings complement emerging randomized trial data and suggest that multimodal treatment strategies warrant further investigation in MCC.